PREGNANCY-BIRTH Messages for July, 2002: Re: 3rd try for answer...Thalassemia and hematocrit

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Re: 3rd try for answer...Thalassemia and hematocrit

From: R. Daniel Braun, MD (anonymous@obgyn.net)
Wed, 3 Jul 2002 18:24:11 -0500 (CDT)

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In reply to: Susan: "3rd try for answer...Thalassemia and hematocrit"

At Wed, 3 Jul 2002, Susan wrote: >
>This is a repost from last week. I have Beta Thalassemia Minor trait
>and am currently 29w1d pregnant with my second child. I am 33 yo and am
>ordinarily anemic and suffer with some other uncommon, but recognized,
>symptoms due to the trait (tendency towards migraine, intolerance of
>heat, inability to sustain aerobic workout, etc). In any case, in both
>my pregnancies, I have had low hemoglobin and hematocrit--hemoglobin as
>low as 7 in my last pregnancy. In addition to prenatal vitamins, I am
>on iron supplements with folic acid once per day and eating a high iron
>diet with the idea that the iron deficiency caused by the pregnancy can
>be treated even though the thalassemia won't respond.
>
>My current OB doc is monitoring my levels every 6 weeks. Initial
>studies indicated hemoglobin 11.1 and hematocrit of 31. It was somewhat
>improved last time--don't know hemoglobin, but hematocrit was up to 32.
>This time, (6 weeks later, mind you!) my hematocrit was 53?!?!?! Is this
>possible in only 6 weeks time, or is lab error likely??

Lab error most likely.

Further, if it >is correct, is this healthy? Should I discontinue iron therapy?

I would worry about Iron toxicity. People with hemolytic anemias do not lose iron and if they are heavily replaced, they may get Iron Toxicity.

I live >in a rural community and my doc is currently unavailable locally. I
>would love it if someone could give me an idea of what may be going on.
>Thanks in advance!

--
R.Daniel Braun, MD  FACOG   FOG
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