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Published in: International Journal of Hematology 3/2023

21-07-2023 | Hydrops Fetalis | Original Article

Ten years’ experience in prenatal diagnosis of α-thalassemia in a municipal hospital and retrospective analysis of ultrasonic abnormalities

Authors: Haijun Li, Jinhua Wang, Degang Wang, Yujie Gan, Yi Xiong

Published in: International Journal of Hematology | Issue 3/2023

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Abstract

Objective

This study reviewed and analyzed the prenatal diagnosis experience of thalassemia in our center over the past decade and the abnormal ultrasonic characteristics of fetuses with hemoglobin (Hb) Bart’s hydrops fetalis.

Methods

Pregnant women and their partners who tested positive for α0-thalassemia or were diagnosed with thalassemia intermedia (HbH diseases) underwent genetic counseling, and a prenatal diagnostic procedure for α-thalassemia was recommended. Ultrasonography was performed before prenatal diagnosis.

Results

Invasive prenatal α-thalassemia diagnosis and ultrasonography were performed in 1049 patients at risk for Hb Bart’s hydrops fetalis syndrome at our hospital from 2012 to 2021. Chorionic villus sampling (CVS) was performed in 58 cases (5.5%), amniocentesis in 902 cases (86%), and cordocentesis in 89 cases (8.5%). Hb Bart’s hydrops fetalis syndrome was diagnosed in 280 fetuses. The most common body cavity effusion was pericardial effusion, ascites, and fetal systemic edema.

Conclusions

The extensive experience at our center shows that carrier screening, molecular diagnostics, genetic counseling, and prenatal diagnosis are effective measures to prevent Hb Bart’s hydrops fetalis syndrome. The ultrasonographic abnormalities in fetuses with Hb Bart’s hydrops are mainly caused by an increase in cardiac output, which leads to the body cavity effusion from various organs.
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Literature
1.
go back to reference Higgs DR, Vickers MA, Wilkie AO, Pretorius IM, Jarman AP, Weatherall DJ. A review of the molecular genetics of the human alpha-globin gene cluster. Blood. 1989;73(5):1081–104.CrossRefPubMed Higgs DR, Vickers MA, Wilkie AO, Pretorius IM, Jarman AP, Weatherall DJ. A review of the molecular genetics of the human alpha-globin gene cluster. Blood. 1989;73(5):1081–104.CrossRefPubMed
2.
go back to reference Iarovaia OV, Ulianov SV, Ioudinkova ES, Razin SV. Segregation of α- and β-Globin Gene Cluster in Vertebrate Evolution: Chance or Necessity? Biochemistry (Mosc). 2022;87(9):1035–49.CrossRefPubMed Iarovaia OV, Ulianov SV, Ioudinkova ES, Razin SV. Segregation of α- and β-Globin Gene Cluster in Vertebrate Evolution: Chance or Necessity? Biochemistry (Mosc). 2022;87(9):1035–49.CrossRefPubMed
3.
go back to reference Weatherall DJ, Clegg JB. Inherited haemoglobin disorders: an increasing global health problem. Bull World Health Organ. 2001;79(8):704–12.PubMedPubMedCentral Weatherall DJ, Clegg JB. Inherited haemoglobin disorders: an increasing global health problem. Bull World Health Organ. 2001;79(8):704–12.PubMedPubMedCentral
4.
go back to reference Muncie HL Jr, Campbell J. Alpha and beta thalassemia. Am Fam Physician. 2009;80(4):339–44.PubMed Muncie HL Jr, Campbell J. Alpha and beta thalassemia. Am Fam Physician. 2009;80(4):339–44.PubMed
5.
go back to reference Li D, Liao C, Li J, Xie X, Huang Y, Zhong H. Detection of alpha-thalassemia in beta-thalassemia carriers and prevention of Hb Bart’s hydrops fetalis through prenatal screening. Haematologica. 2006;91(5):649–51.PubMed Li D, Liao C, Li J, Xie X, Huang Y, Zhong H. Detection of alpha-thalassemia in beta-thalassemia carriers and prevention of Hb Bart’s hydrops fetalis through prenatal screening. Haematologica. 2006;91(5):649–51.PubMed
6.
go back to reference King AJ, Higgs DR. Potential new approaches to the management of the Hb Bart’s hydrops fetalis syndrome: the most severe form of α-thalassemia. Hematology Am Soc Hematol Educ Program. 2018;2018(1):353–60.CrossRefPubMedPubMedCentral King AJ, Higgs DR. Potential new approaches to the management of the Hb Bart’s hydrops fetalis syndrome: the most severe form of α-thalassemia. Hematology Am Soc Hematol Educ Program. 2018;2018(1):353–60.CrossRefPubMedPubMedCentral
7.
go back to reference Chui DH, Waye JS. Hydrops fetalis caused by alpha-thalassemia: an emerging health care problem. Blood. 1998;91(7):2213–22.CrossRefPubMed Chui DH, Waye JS. Hydrops fetalis caused by alpha-thalassemia: an emerging health care problem. Blood. 1998;91(7):2213–22.CrossRefPubMed
9.
go back to reference Xu XM, Zhou YQ, Luo GX, et al. The prevalence and spectrum of alpha and beta thalassaemia in Guangdong Province: implications for the future health burden and population screening. J Clin Pathol. 2004;57(5):517–22.CrossRefPubMedPubMedCentral Xu XM, Zhou YQ, Luo GX, et al. The prevalence and spectrum of alpha and beta thalassaemia in Guangdong Province: implications for the future health burden and population screening. J Clin Pathol. 2004;57(5):517–22.CrossRefPubMedPubMedCentral
10.
go back to reference Liao C, Pan M, Han J, et al. Prenatal control of Hb Bart’s hydrops fetalis: a two-year experience at a mainland Chinese hospital. J Matern Fetal Neonatal Med. 2015;28(4):413–5.CrossRefPubMed Liao C, Pan M, Han J, et al. Prenatal control of Hb Bart’s hydrops fetalis: a two-year experience at a mainland Chinese hospital. J Matern Fetal Neonatal Med. 2015;28(4):413–5.CrossRefPubMed
11.
go back to reference Liao C, Wei J, Li Q, Li J, Li L, Li D. Nonimmune hydrops fetalis diagnosed during the second half of pregnancy in Southern China. Fetal Diagn Ther. 2007;22(4):302–5.CrossRefPubMed Liao C, Wei J, Li Q, Li J, Li L, Li D. Nonimmune hydrops fetalis diagnosed during the second half of pregnancy in Southern China. Fetal Diagn Ther. 2007;22(4):302–5.CrossRefPubMed
12.
go back to reference Lai K, Li S, Lin W, et al. Invasive prenatal diagnosis of α-thalassemia to control Hb Bart’s hydrops fetalis syndrome: 15 years of experience. Arch Gynecol Obstet. 2018;298(2):307–11.CrossRefPubMed Lai K, Li S, Lin W, et al. Invasive prenatal diagnosis of α-thalassemia to control Hb Bart’s hydrops fetalis syndrome: 15 years of experience. Arch Gynecol Obstet. 2018;298(2):307–11.CrossRefPubMed
13.
14.
go back to reference Jatavan P, Chattipakorn N, Tongsong T. Fetal hemoglobin Bart’s hydrops fetalis: pathophysiology, prenatal diagnosis and possibility of intrauterine treatment. J Matern Fetal Neonatal Med. 2018;31(7):946–57.CrossRefPubMed Jatavan P, Chattipakorn N, Tongsong T. Fetal hemoglobin Bart’s hydrops fetalis: pathophysiology, prenatal diagnosis and possibility of intrauterine treatment. J Matern Fetal Neonatal Med. 2018;31(7):946–57.CrossRefPubMed
15.
go back to reference Chankhunaphas W, Tongsong T, Tongprasert F, et al. Comparison of the performances of middle cerebral artery peak systolic velocity and cardiothoracic diameter ratio in predicting fetal anemia: using fetal hemoglobin Bart’s disease as a study model. Fetal Diagn Ther. 2021;48(10):738–45.CrossRefPubMed Chankhunaphas W, Tongsong T, Tongprasert F, et al. Comparison of the performances of middle cerebral artery peak systolic velocity and cardiothoracic diameter ratio in predicting fetal anemia: using fetal hemoglobin Bart’s disease as a study model. Fetal Diagn Ther. 2021;48(10):738–45.CrossRefPubMed
16.
go back to reference Thammavong K, Luewan S, Tongsong T. Performance of fetal cardiac volume derived from VOCAL (Virtual Organ Computer-Aided AnaLysis) in predicting hemoglobin (Hb) Bart’s disease. J Clin Med. 2021;10(20):4651.CrossRefPubMedPubMedCentral Thammavong K, Luewan S, Tongsong T. Performance of fetal cardiac volume derived from VOCAL (Virtual Organ Computer-Aided AnaLysis) in predicting hemoglobin (Hb) Bart’s disease. J Clin Med. 2021;10(20):4651.CrossRefPubMedPubMedCentral
Metadata
Title
Ten years’ experience in prenatal diagnosis of α-thalassemia in a municipal hospital and retrospective analysis of ultrasonic abnormalities
Authors
Haijun Li
Jinhua Wang
Degang Wang
Yujie Gan
Yi Xiong
Publication date
21-07-2023
Publisher
Springer Nature Singapore
Published in
International Journal of Hematology / Issue 3/2023
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-023-03643-6

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