MRCOG Part 2 Mini Combo – Thalassaemia in Pregnancy EMQ GTG No 66

Option List:
A. Oral Iron with Vitamin C
B. Desferoxamine
C. Parentral iron
D. Blood transfusion
E. Folic acid 5mg
F. Alpha thalassaemia
G. Beta thalassaemia
H. Iron-deficiency anaemia
I. Folic acid deficiency
J. Women should receive low-molecular-weight heparin prophylaxis only while in hospital, and should be discontinued on discharge.
K. LMWH should be administered for 6 weeks post discharge following vaginal delivery
L. LMWH should be administered for 7 days following vaginal delivery
M. Intravenous desferrioxamine 2 g over 24 hours for the duration of labour.
N. Chelation therapy not recommended
O. Continue oral desferroxamine as previously
P. Switch to chelation therapy as before pregnancy

1. A woman of Mediterranean origin is treated in pregnancy with high-does folate for anaemia. She has chronic anaemia and, outside of pregnancy, requires recurrent transfusions and has to have iron chelation therapy following this.

2. How is anemia in a patient with Thalassemia Major managed in antenatal period?

3. What management should be done in intrapartum period to prevent iron overload in woman with thalassaemia major who are dependent on transfusion?

4. Which of the following is correct regarding thromboprophylaxis after vaginal delivery in thalassaemia major patients?

5. What prophylaxis should be advised in post partum period to prevent iron overload if woman chooses to breastfeed?

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