pregnant with thal minor & suspected anemia

Hi all..

im so happy to find this forum. it has given me a lot of hope & understanding.im from Malaysia
First of all, i was diagnosed with thal minor during my early 20's. i have no idea where i inherit this becaus both my parents are normal. but according to the doctor, it is maybe because my parents were cousins. i was pregnant with my first child when i was 30 years old. the first few month was amazing. the problem surfaced when i was in my 5th month. i have low HB, about 10.9. i have informed the doctor that i have thal minor, so they said it normal. they just ask me to eat iron rich food & fruits, which i did. during the 6h months check up, my HB dropped to 9.9. as they know that im thal minor, they just ignore the fact of my low HB. i continue my vitamin intake & healthy diet as recommended by the doc. i have started having sleeping problem since the 5th month pregnancy. i sleep only for 1 hour a day. im very tired, easily get frusrated, lack of focus, dizzy, & my leg starting to swell. 2 days before my 7th month check up, i cant sleep the whole night, having back pain, feverish, dizzy,.but the swelling on my leg reduced. i went to the check up alone as my husband was having an important meeting. i were told that i have high BP, but my HB is normal 11.00.due to the complications, i wasdirectly send to the hospital & c section was done the next day. my baby is only 1.1 kg and born as pre term baby. at that time till now ...i was thinking that i have high BP during pregnancy.

now im pregnant with my second child, since the 3rd moth pregnancy, my HB is low but my bp is normal. as the doctor have my previous record, the know that im prone to low HB.now im 17 weeks pregnant and im having the same symptoms such as dizzy, hearts papilation, tired, easliy get angry & frustrated, headache, body ache, feverish, hard to sleep, and the most importnat , my leg are swelling plus i have ventrikose vein. (i inherit this from my mum). after reading all the notes from the forum im starting to feel that people dont really understand our situation. they are still thinking thetthal minor people can lead  normal life, i think its wrong... especially when u r pregnant with thal minor... i want to fight for my self & my baby... im understanding myself better nowadays & i want to prepare myself & my husband for the battle, but i need advice & support from ths forum as weel so that, i wont go to the operation room unprepared. i want to prepare myself & my baby as soon as i can. futhermore i was involved in an accident during my 15th week pregnancy, it still hurts my back. now i cant really sit for very long period, or walk for long distance or stand for long period. it really make me sad but i need to be strong for my baby...thanks all-Yasmin

Welcome to thalpal - I think you are at the right forum as there is a lot of mom's who had thal(minor) who have shared their experience and to-do's on this site. Please refer to the Pregnancy for Thal Minor post at http://www.thalassemiapatientsandfriends.com/index.php/topic,3041.0.html

One thing you might want to do is make sure you are taking vitamins that can help your over all health. Let us know if you have questions and members can try to answer it.

Dear friends

I had a query specific to my iron levels during my current pregnancy. I am thal minor 29 weeks pregnant and my HB level is around 9.8 with ferritin level 30. When i was 16 weeks pregnant my ferritin level was 11 so I was put oniron supplement sangobion (2 doses 250mg each). Now my ferritin level is 30 but HB still low at 9.8. My doctor has changed my supplement and asked me to take a syrup called ferrum haussman (abt 100mg dose twice).

Am I being given the supplements correctly? I dont feel very tired or breathless as such but at the end of the day when I am back from work I have swelling around my feet and ankles. Is there anything I need to worry about. Please advise.

Your Hb will drop during pregnancy when you are thal minor, regardless of how much iron you take. Part of the reason is that you carry more fluid when you're pregnant and it causes a dilution but it isn't a true Hb drop. The other part of it is simply being a thal minor, as your body does not have the capacity to build as many red blood cells as would be needed to keep your Hb higher. This will not affect the baby.
Your ferritin was low and was somewhat corrected by taking iron. It is in the low normal range now. I don't think iron will harm you at this point, so it won't hurt to take it, but you also can't expect your Hb to rise during the pregnancy. Yours is actually fine for a thal minor this far into the pregnancy. Transfusions should not be considered unless the HB drops in the 7-8 range and you are also feeling exhausted most of the time. If you aren't taking folic acid, start immediately and then scold your doctor for not having you on it from the beginning, as all pregnant women should take it, but it is very important for minors during pregnancy as it is essential for building red blood cells. It also helps to prevent birth defects and any doctor not making it mandatory during pregnancy should not be treating women at all.

Hi Andy

Thanks for the assurance. I have been on folic acid even before I got pregnant. But I have been on a 500mcg dose obly. I have seen u recommend 1000mcg to some. Do you think I should ask my doctor to inceease my folic dose?

Most doctors are not aware of the heightened need for folic acid in thal minor pregnancies. I regularly recommend 2-5 mg for pregnant minors. The high doses really do appear to make a difference in Hb level and also reduce problems in general during the pregnancy. The problem is that there have been so few studies of thal minors, that there's nothing to point to as evidence, other than anecdotal reports, like we receive here. Ask your doctor about raising the dose. Folate is required to build red blood cells and this isn't as easy for thal minors as it is for non-thals during pregnancy. A higher dose would be beneficial.

Thanks a lot for your advise. I will speak to my doctor about this ASAP.

I am so glad I found this forum! I am 9 weeks pregnant and have thal minor. I have been told my whole life to not take iron supplements so when my OB called me yesterday in a panic about how anemic I was ( Hb at 9.2 and low hemocrit) and telling me I had to start taking iron right now - starting at 325mgs then increasing ina week to 650mgs - I told her no way. Good thing I did because they don't have the bloodwork.back yet with my actual iron levels .  I will also talk to my doctor about increasing my folic acid intaKe. I take 800 right now. I also will mention the clotting problem Andy was talking about in other posts between the placenta and uterus. One question though, I realize there seems to be no way to raise your hemoglobin but does having such low hemoglobin affect the babies' development at all? And is there anything else I should be talking to my doctor about? And I get plenty of vitajin d so I'm not worried about that. Thanks for this website!