Selection of couple at risk of having fetus with hemoglobin Bart’s hydrops fetalis: 6 years of experience at Suratthani hospital

Abstract

Selection of proper risk couples for analysis of α-thalassemia 1 gene is an important step in   effective prevention and control program of Hb Bart’s hydrops fetalis. We evaluated in this study the  suitability of the selection performance of at risk couples for α-thalassemia 1 in the past 6 years (August 2006 – December 2011) at Suratthani hospital. From 433 couples with positive in primary screening with MCV/OF, DCIP and Hb analysis, 367 (86.8 %) were subjected to analysis of α-thalassemia 1. Of these, only 170 (39.3 %) were real couples at risk. In the remaining 206 inappropriate couples with no risk, 149 (34.3 %) had no risk of α-thalassemia 1 in one partner and 57 (13.2 %) had no risk in both of them. In contrast, no α-thalassemia 1 was investigated for 11 (2.5 %) couples with true risk. The result indicates a need for establishment of standard selection guideline from the results of initial screening and Hb analysis as well as an appropriate training course on laboratory interpretation of thalassemia for the staffs. These should improve the efficiency of a prevention and control program of Hb Bart’s hydrops fetalis and should significantly reduce cost of a-thalassemia 1 analysis in unnecessary couples as exemplified by a total of 494,400 baht for the 6 years period of this study.

Keywords: Hb Bart's hydrops fetalis, α-thalassemia 1, Prevention and control of thalassemia