Little is known about the outcome of pregnancy in women with
beta-thalassemia intermedia (TI). Over 10 years, maternal and neonatal outcomes of women with TI followed at a single
thalassemia center were reviewed. Nine spontaneous pregnancies in five women with TI were studied. Six pregnancies resulted in live newborns; two were complicated by first-trimester abortions and one by an unexplained intrauterine
fetal death at 36 weeks' gestation. Two patients had
splenectomy before pregnancy: one required cesarean delivery and
splenectomy at 31(2/7) weeks' gestation for worsening
hemolytic anemia and
thrombocytopenia and another had
splenectomy 8 weeks postpartum for symptomatic
hypersplenism. Two patients had received transfusions before pregnancy, and two required them for the first time during pregnancy and developed
antibodies, which contributed to worsening of their
anemia and repeated transfusions. The mean number of transfusions received during pregnancy was 8.0 +/- 5.2 units. The mean lowest
hemoglobin level in pregnancy was 5.2 +/- 2.0 g/dl. Cesarean delivery was performed in 42.9% of cases. Mean gestational age at delivery was 36.7+/- 3.1 weeks with
intrauterine growth restriction (IUGR) complicating 57.1% of cases. In conclusion, IUGR complicates more than half of pregnancies with TI. Transfusions are needed in most cases, even in non-transfusion-dependent patients. Postpartum
splenectomy might be necessary in some patients.