Intrauterine therapy for homozygous alpha-thalassemia.
BACKGROUND
Alpha-thalassemia is one of the most common genetic disorders in the world and is becoming more common in the United States with the increase in immigration of susceptible populations. This disease has been stated previously to be incompatible with extrauterine life.


METHODS
A Filipino woman with a prior loss due to hemoglobin Bart's underwent prenatal diagnosis that confirmed recurrence in the index pregnancy. Intravascular intrauterine exchange transfusions maintained appropriate fetal growth. A cesarean delivery yielded a 2190-g male infant with minor malformations. The postnatal course was characterized by mild respiratory insufficiency. Postnatal chronic transfusion therapy is underway pending consideration for bone marrow transplantation.


CONCLUSIONS
Antenatal diagnosis and therapy of homozygous alpha-thalassemia can prevent the prenatal consequences of hydrops and fetal death. New technologies such as stem cell transplantation may help to avert both prenatal and postnatal consequences.
Carr
S
S
Division of Maternal-Fetal Medicine, Brown University School of Medicine/Women and Infants Hospital, Providence, Rhode Island, USA.
Rubin
L
L
Dixon
D
D
Star
J
J
Dailey
J
J
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging; D000328:Adult; D001034:Apgar Score; D001805:Blood Transfusion, Intrauterine; D002585:Cesarean Section; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D005817:Genetic Counseling; D006720:Homozygote; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging*; D007231:Infant, Newborn; D008297:Male; D010679:Philippines / Q000208:ethnology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D012008:Recurrence; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis*; D016216:Ultrasonography, Prenatal; D017085:alpha-Thalassemia / Q000235:genetics* / Q000628:therapy