title: Fertility in beta thalassaemia major: a report of 16 pregnancies, preconceptual evaluation and a review of the literature.
abstract: OBJECTIVE
  To examine the pregnancies, mode of delivery and outcomes, review the literature on fertility and discuss preconceptual guidance for women with beta thalassaemia major.
  
  
  METHODS
  An observational study.
  
  
  METHODS
  Sixteen women with beta thalassaemia major.
  
  
  METHODS
  Two collaborating London teaching hospitals.
  
  
  METHODS
  Pre-pregnancy assessment, pregnancy course, mode of delivery, gestational age at delivery and birthweight.
  
  
  RESULTS
  There were 16 pregnancies in 11 women. Three of these pregnancies were terminated. Of the 13 deliveries, there were two normal deliveries, one forceps delivery and 10 caesarean sections. The main findings in a further five women seeking fertility treatment were of hypogonadotrophic hypogonadism, diabetes and cardiomyopathy.
  
  
  CONCLUSIONS
  Pregnancy in women with beta thalassaemia major does not appear to have a deleterious effect on the course of the disease. No increased obstetric complications were encountered except for the high caesarean section rate, essentially due to cephalopelvic disproportion. A high incidence of cardiomyopathy and diabetes dictates a careful assessment before embarking on ovulation induction to treat the hypogonadotrophic hypogonadism which is common in these women.
authors.affiliation: Department of Obstetrics and Gynaecology, Royal Free Hospital and School of Medicine, London, UK.
authors.forename: C E
authors.initials: CE
authors.lastname: Jensen
authors.forename: S M
authors.initials: SM
authors.lastname: Tuck
authors.forename: B
authors.initials: B
authors.lastname: Wonke
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy; D008423:Maternal Age; D010062:Ovulation Induction; D016742:Preconception Care; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000209:etiology*; D011256:Pregnancy Outcome; D017086:beta-Thalassemia / Q000150:complications*