An Assessment of Couples at Risk of Having a Child with Severe Thalassemia at Kumphawapi Hospital, Udon Thani

Jirayu Phaphong

Abstract


The guidance for screening severe thalassemia among high risk carrier couples has been developed in Kumphawapi Hospital, Udon Thani Province, according to the prevention and control policy of thalassemia of the Ministry of Public Health. All pregnant women and their husbands, who attended the antenatal care (ANC) services at the hospital, are screened for thalassemia using a combined mean cell volume (MCV) and dichlorophenolindophenol test (DCIP Test). The Hb typing using low performance liquid chromatography (LPLC) is ordered when positive screening results are found in both pregnant women and their husbands. The polymerase chain reaction (PCR) for analysis of  α-thalassemia 1 or β-thalassemia trait is   performed in samples suspected of that gene. In order to evaluate the guidance for screening severe thalassemia among high risk carrier couples, retrospective data from October 2013 to May 2015 at ANC clinic of Kumphawapi Hospital were collected and analyzed. One thousand and eighty eight pregnant women were attended during the analysis period and 578 (53.1%) of pregnant women were positive for thalassemia carrier screening.  Of the 578 wives positive for thalassemia carrier screening 468 (81.0%) of husbands were screened and 193 (41.2%) were positive for thalassemia carrier. From Hb typing analysis, 43 (22.3%) were found to be at-risk couples and 5 out of 193 couples (2.6%) were found to be at risk of having fetuses with Hb Bart’s hydrops fetalis, β- thalassemia /Hb E disease and β-thalassemia major when analysed with α –thalassemia and β –thalassemia genetic tests. To achieve more efficient  prevention and control program of thalassemia and hospital service of this disease, the integration of laboratory services, ANC clinic and counselling are required to improve the screening for severe thalassemia among high risk carrier couples by testing both pregnant women and their husbands for thalassemia when they attend ANC clinic.

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