A reliable screening protocol for thalassemia and hemoglobinopathies in pregnancy: an alternative approach to electronic blood cell counting.
Primary screening for thalassemia and hemoglobinopathies usually involves an accurate blood count using an expensive electronic blood cell counter A cheaper alternative method was tested by using a modified osmotic fragility (OF) test and a modified dichlorophenolindophenol (DCIP) test. Altogether 423 pregnant Thai women participated in this project. Hemoglobin patterns and globin genotypes were determined using an automated high-performance liquid chromatography analyzer and polymerase chain reaction analysis of alpha- and beta-globin genes. Among the 423 subjects, 264 (62.4%) carried thalassemia genes. The combined OF and DCIP tests detected all pregnant carriers of the 3 clinically important thalassemias, ie, alpha0-thalassemia, beta-thalassemia, and hemoglobin E with a sensitivity of 100.0%, specificity of 87.1%, positive predictive value of 84.5%, and negative predictive value of 100.0%, which show more effectiveness than these values for the standard method based on RBC counts. A combination of modified OF and DCIP tests should prove useful and applicable to prenatal screening programs for thalassemia and hemoglobinopathies in communities with limited facilities and economic resources.
Sanchaisuriya
Kanokwan
K
Graduate School, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand.
Fucharoen
Supan
S
Fucharoen
Goonnapa
G
Ratanasiri
Thawalwong
T
Sanchaisuriya
Pattara
P
Changtrakul
Yossombat
Y
Ukosanakarn
Uthai
U
Ussawaphark
Wichai
W
Schelp
Frank P
FP
D000328:Adult; D001772:Blood Cell Count / Q000379:methods*; D004582:Electronics, Medical; D004909:Erythrocyte Indices; D005260:Female; D006453:Hemoglobinopathies / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D009996:Osmotic Fragility; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000175:diagnosis*; D013789:Thalassemia / Q000097:blood / Q000175:diagnosis*