Thalassemia > Pregnancy > Iron Chelation

Iron chelation

Removing excess iron through the use of chelating medication is critical to the health and longevity of the woman with thalassemia. Increased transfusion requirements during pregnancy may increase the need for chelation therapy. However, the safety of desferrioxamine (Desferal) during pregnancy has not been established; it is unclear whether this medication poses any risk to the developing fetus. Depending in part on the quantity of liver iron stores, temporarily discontinuing the use of desferrioxamine may be considered during pregnancy. Some have suggested that pregnancy itself may serve as a chelator of iron, via the uptake of free iron by the developing fetus. Though data on Desferal use during pregnancy is minimal, CHO has experienced two successful pregnancies with a beta thalassemia major patient. As she was severely iron overloaded, she received high dose Desferal through a port throughout both pregnancies. Both infants have thus far experienced no deleterious effects as a result of chelation therapy. The pregnant woman with thalassemia should discuss with her physicians the benefits and possible risks of continuing or discontinuing desferrioxamine use during pregnancy.