Improvements in medical facilities have helped a large number of clinically severe
hemoglobin E (HbE)-β-
thalassemia patients reach adulthood. Consequently, there is a new challenge, that of managing women with HbE-β-
thalassemia during pregnancy. In particular, they have a high risk of abortion, preterm delivery,
intrauterine growth restriction, and
thromboembolism. A 27-year-old HbE-β-
thalassemia patient on regular transfusion, who was splenectomized and heptatitis C (HCV)-positive, conceived for the first time without any
infertility treatment. However, there was
incomplete abortion with heavy
bleeding at 3 months of gestation, which required bilateral uterine artery angiography. The angiogram showed the left uterine artery to be moderately hypertrophied. This was embolized with 300-500 micron
polyvinyl alcohol (PVA) to stop the
bleeding. Soon after, she conceived again with a twin pregnancy, and at 33.3 weeks of gestation, there was a normal delivery of twin girls without any
postpartum hemorrhage or perineal tear. Both babies were given prematurity care. The mother and children were both normal up till the last follow-up 18 months after delivery, and both the girls are HbE heterozygous. Thorough monitoring of endocrine functions along with proper management of transfusions and
iron overload can help in reducing the complications related to pregnancy in these patients.