Query on Beta Thalassemia Trait????

Hi Andy!
I want to know that my parents are both normal and they recently were diaganosed  normal in electrophoresis test, however i am beta thal trait....is it possible to get it from grandparents or thal passes from parents only????Does it skip generation?
Help me i am worried in 8th month of pregnancy.....another addition to prob is gestational diabetes hope it doesnt interfere with thal?

Dear mommy in singapore

My husband blood electophoresis showed that he was normal too, but actually he is not because the our kid is intermedia. The reason for this is that his muted gene is a silent carrier that does not appear in blood electophoresis nor the HPLC. The only test that shows his trait  is the DNA sequencing for Beta Globin chains. Thalassemia in general is inherited from parents directly. It doesn't skip a generation.

Hope this helps

Manal

Hi,

As Manal said, thal trait doesn't skip a generation. If neither parent carries the trait, the child can't have it. If you carry the trait. one of your parents also must carry it. The main concern is whether the father of your child also carries any trait.

As far as gestational diabetes, if it is under a doctor's supervision and is under control, it shouldn't be a problem.

From http://www.marchofdimes.com/pnhec/188_1025.asp

Pregnancy-Induced Diabetes

About 3 to 5 percent of pregnant women develop diabetes for the first time during pregnancy. This type of diabetes, called gestational diabetes, occurs when pregnancy hormones interfere with the body’s ability to use insulin—the hormone that turns blood sugar into energy—resulting in high blood sugar levels. You are at increased risk if you are over age 30, obese, have a family or personal history of diabetes, or previously gave birth to a baby who weighed more than 9 pounds or was stillborn.

If a woman with gestational diabetes isn’t treated, her fetus will receive too much blood sugar and may grow very large. Oversized babies are at risk of birth injuries during vaginal delivery, so they often must be delivered by c-section. Babies of mothers with gestational diabetes also can have breathing difficulties, low blood sugar and jaundice during the newborn period.

Most women with gestational diabetes have no symptoms, though a few may experience extreme hunger, thirst or fatigue. Your health care provider will probably screen you for gestational diabetes between your 24th and 28th week of pregnancy. At the screening, you’ll drink a sugary liquid and then take a blood test one hour later. If your blood sugar level is high, you’ll need to take a similar test over three hours to determine whether you have gestational diabetes.

If you do have gestational diabetes, you’ll be able to control it with diet and exercise. Your health care provider or a dietitian will recommend an individualized diet that takes into account your weight, stage of pregnancy and food preferences. Most likely, 10 to 20 percent of your calories should come from protein (meat, poultry, fish), about 30 percent from fats, and the remainder from carbohydrates (pasta, rice, fruits, and vegetables). Sweets might be limited.

At least once a week, you’ll visit your health care provider to get your blood sugar levels checked. If your diet fails to stabilize your blood sugar levels after about two weeks, you’ll probably have to give yourself daily insulin shots throughout your pregnancy and monitor your blood sugar levels at home.

While gestational diabetes generally goes away after delivery, women who get it face about a 50 percent risk of developing diabetes later in life and also have a 50 percent chance of gestational diabetes in another pregnancy. Starting a weight loss and exercise program after delivery can help reduce your risk.

There are quite a few Thal(Minor)'s who were NOT diagonised with Thal(Trait) when the Electrophoresis was done. (It does NOT seem to be reliable in all cases). As Manal mentioned, it is a good idea to get the DNA test done to find out the confirmed results

Also, the most important thing for you right now, is to know if your husband is a Thal(Trait). Only 1 parent being a Thal(Minor) - would NOT be a major problem for your child.

-Narendra

Thanks you all for your help....I had checked my husband and older son for the thal...luckily both are normal......

I have advised my mom to go for the DNA test for thal as her readings were higher for hb A.

Thanks again and yes i am controlling my diet well.

Some carriers of thalassemia can be silent and tests and electrophoresis tests may not always detect them. I get asked a lot if the gene skips generations, but it doesn't. Alpha thal carriers often go undetected with electrophoresis.

Other common complications are:

Confirmation by Hb electrophoresis in b thalassemia is essential before the patient and the family are counseled. The Mentzer index loses its value if the patient has a combination of thalassemia and iron deficiency. In such patients, Hb electrophoresis results may also be inaccurate and misleading, since iron deficiency suppresses production of all Hbs, including Hb A2. For this reason, the Hb A2 level does not rise and is typically normal in these patients, masking the diagnosis of b thalassemia. In such cases, Hb electrophoresis should be repeated after the iron deficiency has been treated to obtain an accurate Hb A2 fraction.

When b and a thalassemia coexist, the elevated levels of Hb A2 and Hb F usually present in b thalassemia may also be lost. Furthermore, a thalassemia ameliorates the severity of b thalassemia since the decrease in a chains results in less inclusions and, hence, less hemolysis.

You can read more about this at:
http://www.emedicine.com/ped/topic2229.htm

HI
     yes am agree with Manal


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