An Indian Case of Beta Thalassemia Trait

By Lynda Bardell

Dr Elizabeth Searle works at a hospital in Jharkhand, India. In August 2019 she referred one of her patients to the Swinfen Charitable Trust. Dr Searle was worried about this 27-year-old lady who was 23 weeks pregnant with her second child. The lady had travelled from a remote jungle area and was feeling unwell. She was anaemic and her haemoglobin was falling despite her taking prescribed iron supplements. The oral supplements were causing uncomfortable and potentially risky side effects. Fortunately, her unborn child appeared to be developing normally.

Further blood investigations showed this young lady had Beta Thalassemia Trait which was increasing her anaemia with potential risk to her health and her unborn child. The patient’s first child was born almost two years previously by caesarean section after labour difficulties. Consequently, the patient was expected to deliver her second child by caesarean section again. As the lady lived in a remote area, if there was a problem during the pregnancy or especially at caesarean section, a blood transfusion would not be available unless she was able to move to a large medical facility in a city. The family had no means to facilitate this. Dr Elizabeth required expert advice on whether a blood transfusion was the only safe way to raise the patient’s haemoglobin and what implications the diagnosis of Beta Thalassemia Trait would have on the pregnancy and the unborn child.

Dr Elizabeth reached out to the Swinfen Charitable Trust via the telemedicine referral link. The next day she received advice and information from two of the Trust’s consultants who concurred that pregnancy outcomes and obstetric complications should be no different for her patient than those in the general population. The consultants continued to support Dr Elizabeth, with advice and suggestions, as she managed her patient’s medical complications throughout the remainder of the pregnancy.

A message came from Dr Elizabeth just before Christmas to report that the lady had undergone emergency caesarean section at 37 weeks and had a healthy 2.6 kg girl. Both mother and baby were doing well. All Swinfen volunteers involved in the referral were overjoyed at this wonderful news. Without the Swinfen telemed link available to Dr Elizabeth in India the outcomes for this mother and baby may have been quite different.