Thal minor and recurrent miscarriages

Hi everyone,

Although I have had three healthy children, my eldest two were born when I was 20 and 23 years old respectively.  My third child was born when I was 37 and since his birth I have had three miscarriages.  The first loss was in August 2008 (I was 9 wks), the second in February 2009 (13 wks) and the last one, two weeks ago (15wks) - I turned 40 this past Sunday.

Even though I've been told since I was 19 (when I discovered that I had Thal Minor) that I would be asymptomatic, I have long thought otherwise.  I just recently found info online where other Thal Minor carriers expressed the same thing.  I am so happy to have found this site!  I am convinced that as I have become older, the symptoms are more pronounced and have a greater effect on me.  I have ALWAYS been low-energy/lethargic at times, mildly depressed, short of breath just bending over to pick something up etc!  Same story of doctors not giving much attention to the Thal minor.  Of course, having a toddler is tiring, but I have been beyond exhausted since my son was born.  With my first pregnancy, I was young and didn't seem to need any extra iron, but even by the second pregnancy my OB was concerned and gave me iron injections as my levels were getting low.  Fast forward 14 years to my third pregnancy and this OB was going to give me transfusions as my levels were at an all-time low!  I managed to get my levels within a (barely) acceptable range by taking Floradix iron supplement and so transfusions weren't needed in the end.  But, since then, I have had these three sad losses.  My hunch is that my levels were so depleted with my last successful pregnancy, compounded by being older now, that not enough has been done to bring my levels up to an optimum (as much as it can be for a Thal minor) in order to sustain pregnancy.

I see my OB again in a few weeks and now that I'm armed with more info I'm going to be telling him all about this.

Anyone else experience something similar and have some encouraging words should we try again for another baby?

Any insight is appreciated

I am on my way too bed, so havent read further that title.
It is recommend to start taking 5mg folic acid daily 3 months before.
I Will come back to you. If i dont, sent me à message please.

Warm wishes, Dore

Hi sproutsma


  to our forum ,I hope you get the answers to your questions,
Kathy

Hi Sproutsma
 

Umair

Dear Sproutsmama,

Pregnancy is thal minor can cause significant anemia.  Some anemia is normal in all pregnant , because of the increased volume of plasma in the body - hemoglobin can appear to be lower than it is, also the demands of the growing fetus can cause depletion of iron stores and lower hemoglobin.  In thalassemic women this anemia becomes more pronounced as the the body may have more trouble keeping up with the increased hemoglobin requirement.  The spleen can become enlarged during pregnancy as well because of the anemia, the spleen increases its surface area to create more hemoglobin. 

In subsequent pregnancies this anemia is usually more pronounced than the first or second.  I don't know if your miscarriages are related to thalassemia minor, however the miscarriage rate is much higher when you are close to 40 years of age. 

I think it should be fine for you to try to achieve another pregnancy, I would suggest that you try to increase you hemoglobin naturally before becoming pregnant.  We have suggested many supplements in the diet and nutrition section such as folic acid, wheat grass, carao that you can try in order to increase your hemoglobin.  Because this will be your fourth child, and because you have had miscarriages you may be more prone to significant anemia therefore you will need to take precautions and you may even require 1 or more transfusions during pregnancy.  It would be a good idea to see a hematologist while you are pregnant. 

Best of luck in what you decide, feel free to post other questions and concerns,

Sharmin

Sproutsmama,

Here is a link to the posts that talks about Pregnancy and Thal (Minor).
http://www.thalassemiapatientsandfriends.com/index.php?topic=3041.0


Also, there is a link to a couple loosing their child in the post.
Lost a baby during pregnancy
http://www.thalassemiapatientsandfriends.com/index.php?topic=2866.0

Hi Sproutsmama,

Please review the many posts on this subject. In thal major it is well known that clotting between the placenta and uterus can cause miscarriages as the flow of blood diminishes to the point that the fetus cannot survive. From the amount of moms that have reported miscarriages in thal minor pregnancies, I would have to say the same thing is happening to minors. Talk to your doctor about testing for clotting during pregnancy. This is an issue that can be dealt with as long as it is suspected as a problem. It may be as simple as taking a daily aspirin during pregnancy. I would recommend 400 IU natural vitamin E daily, as it can keep the blood a bit thinner so that clotting is less likely.

Hi again,

thank you so much for your responses........I did read all the posts in the links that you sent

I just received the hospital report from when I miscarried two weeks ago.....I'm not sure how to read the CBC stuff, but I did note that the hemotologist wrote 'moderate anemia noted'.   I miscarried on Tuesday, Aug. 18 and on the Saturday or Sunday just before, I felt like I'd hit a wall!  I suddenly became very lethargic and drained - as if every last drop of enery I had left had evaporated.  This tiredness was well over and above the usual tiredness associated with pregnancy.  Perhaps that was a sign that some critical levels of hemoglobin etc. were dropping.

I do happen to think more and more that my Thal is somewhat responsible for what's been happening to my pregnancies.  I feel both happy that the future may yet bring us another baby, but also sad that maybe, just maybe we might not have lost our three little ones had I and my doctors paid more attention to my thal.

I see my OB in early Oct. and that's when he'll start running tests....I'll be sure to ask about clotting issues etc.

Will keep you posted.

Elizabeth

 

Dear Sproutsmama,

I am very sorry for your losses.   I am glad to know that you are going to get help for a better outcome in the future.  My best to you. 

Take good care,

Sharmin

Hi Sharmin,

Thank you for your kind words.  Each day does seem a little brighter.  I have to trust that the future will unfold as it should - I'm hoping that with time, my faith will be restored.

Take care,
Elizabeth

Hi everyone,

thought I'd give you an interim update on my situation.

While I still have a few weeks before I see my obstetrician again, who will start running tests to try to determine the cause(s) of my three consecutive miscarriages, I have already seen my naturopathic doctor.

We reviewed together my last four blood lab results (dating from July 2008 (taken during the first pregnancy that I lost) to August 2009 (blood lab results from hospital following third miscarriage).  These are her overall findings:

Since July 2008 to present -
1) My total number of red blood cells (RBC) has declined.
2) My hematocrit has held steady
3) My "RDW" (sort of a marker of RBC size) has steadily declined
4) My hemoglobin has declined
5) My B12 levels have declined

My family physician has had this information and never once told me that my blood work was coming back like this......she has always 'written off' any low numbers as being 'normal' because of my thal minor.  You can imagine how anxious I am to discuss this with my OB - I will definitely be asking to see a hemotologist now too.

I know that I'm not alone in being ignored as a thal patient.....while I can't prove that my miscarriages are linked to my blood, it's pretty hard to ignore that most likely they are and I do think that my family doctor is ignorant at best and negligent at worst.  Very frustrating and angering! 

I've since started taking 5mg of folic acid along with B12 and my naturopath recommended a 'tissue salts' tonic to boost my energy as well as 'Greens + Multi' - it's a product here in Canada (maybe U.S. too) that has wheatgrass among other good stuff to boost my system.

I hope that in time (I'm taking at least a year off before trying again for another baby) between all these supplements and seeing a hemotologist who will hopefully monitor my next pregnancy closely, that we'll be successful.

Anyway, I wanted you all to know that even if your doctor ignores crucial things, you shouldn't take their word for it - the price is too high.

I'll let you know what come of my visit with my OB on Oct. 16.

Take care everyone,
Elizabeth

Good Luck Elizabeth .

Zaini.

Best of luck Elizabeth,

I wish great health to you, your children and your future child.

Sharmin

Hello Elizabeth,

Finally I have been able to read al the posts which are waiting for me. I hope you are doing well and I do wish you the same as Sharmin wished you.

Warmest wishes, Dore

Hi Dore,

Hope all is well with you - thanks for your post

As it happens, I go tomorrow for blood work to determine whether or not my blood is clotting (thrombophilia) - my obstetrician had sent a referral to hematologist - so this is the first stage of research for me.  The nurse told me that even if the test comes back negative, the hemotologist will still see me b/c of my Thal.  I was very happy to hear that!

It's been three months now since our last pregnancy loss and I think that if we're better informed, we'll be inclined to try again within the year.  So, here's hoping we get some answers!

Elizabeth