Lessons learned from a prenatal diagnosis program for thalassemia in Thailand.

Autor: Wong P; Thalassemia Research Unit, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand., Suannum P; Thalassemia Research Unit, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand., Jermnim S; Thalassemia Research Unit, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand., Charoenporn P; Thalassemia Research Unit, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand., Chan-In M; Thalassemia Research Unit, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand., Tapprom A; Thalassemia Research Unit, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand., Deoisares R; Thalassemia Research Unit, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand.
Jazyk: angličtina
Zdroj: Prenatal diagnosis [Prenat Diagn] 2020 Jul; Vol. 40 (8), pp. 998-1004. Date of Electronic Publication: 2020 May 13.
DOI: 10.1002/pd.5723
Abstrakt: Objective: To assess the outcome of a thalassemia screening program at community hospitals by determining the proportion of at-risk couples able to obtain a prenatal diagnosis (PND) in relation to gestational age (GA).
Methods: We accessed records documenting prenatal screening for thalassemia in lower northern Thailand between January 2014 and December 2016. The proportion of at-risk pregnancies able to obtain a PND was determined and median GAs at the time of at-risk notification were compared. Reasons for failures to obtain PNDs were analyzed.
Results: Among 4633 screen-positive couples, 259 (5.6%) were identified as at-risk while 23 were excluded due to unconfirmed outcomes. Forty-one declined a PND and were excluded from the final calculations. Of the 195 remaining couples, 140 (71.8%) obtained a PND. Their median GA at the time of at-risk notification was 12.4 (5.6-29.1) weeks, which was earlier than the median GA of 17.7 (6.9-34.6) weeks for couples not undergoing PND (P < .001). Risks for various types of thalassemia and GA were associated with the chances of achieving a PND.
Conclusion: In practice, one quarter of couples identified as at-risk were unable to obtain a PND. Time-influencing factors seem to be a major determinant.
(© 2020 John Wiley & Sons, Ltd.)
Databáze: MEDLINE
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