Z6 Thalassemia in Pregnancy Leave a Comment / Blog, Today's Quiz / By obgninja /2 Beta Thalassemia Z6 Thalassemia in Pregnancy 1 / 2 1. Q9 Thalassemia A primigravida at 12 weeks gestation is a case of Thalassemia Major. She underwent splenectomy as a child and is on regular penicillin prophylaxis. Her lab results are as follows- Haemoglobin- 10.1 gm/dL White cell count- 9,000 /microlitre Platelet count – 650 x 10^9/l What will be the recommendation for thromboprophylaxis during pregnancy in this case? A. Low dose Aspirin B. Low molecular weight heparin C. Unfractionated heparin D. None E. Compression Stockings Women with thalassaemia who have undergone splenectomy and have a platelet count above 600 x 10^9/l should be offered low-molecular-weight heparin thromboprophylaxis as well as low-dose aspirin (75 mg/day). If it were only one of splenectomy OR platelet count more than 600 , then aspirin should be started. 2 / 2 2. Q8 Beta thalassemia A woman with beta thalassemia major, at 25 week pregnancy presents with palpitations. she is on regular transfusions and her Haemoglobin is 9 gm/dL. Which of the following will be the next most appropriate step? A. ECG B. Serum ferritin C. Blood transfusion to achieve Hb of 10 If a woman describes symptoms of palpitations then a cardiac assessment is appropriate. Cardiac iron overload can lead to cardiac toxicity. A detailed history, ECG and 24 hour ECG monitor assessment are needed to confirm a pathological cause. Women with thalassaemia major and myocardial iron loading with T2* of < 10 ms are at high risk of cardiac decompensation which may present as increasing breathlessness, paroxysmal nocturnal dyspnoea, orthopnoea, syncope, palpitations or peripheral oedema. Desferrioxamine infusions may be indicated if there are concerns. Your score is The average score is 47% Facebook Twitter Restart quiz
