Indian Journal of Medical Biochemistry

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VOLUME 22 , ISSUE 2 ( July-December, 2018 ) > List of Articles


Antenatal Detection of Hemoglobinopathies using Red Blood Cells Indices for Screening

Sukanya Singh, Mona Tilak

Keywords : Antenatal, β-thalassemia trait, Red blood cell indices, Sickle cell disease/trait.

Citation Information : Singh S, Tilak M. Antenatal Detection of Hemoglobinopathies using Red Blood Cells Indices for Screening. Indian J Med Biochem 2018; 22 (2):100-104.

DOI: 10.5005/jp-journals-10054-0064

License: CC BY-NC 3.0

Published Online: 01-01-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Introduction: Hemoglobinopathies are a group of inherited disorders because of abnormalities in hemoglobin synthesis or structure. Thalassemia and sickle cell anemias are the most prevalent hemoglobinopathies and a national health burden. To reduce this burden, detecting them in the carrier stage is crucial. The health of pregnant women determines the future of the progeny. Hence identifying these disorders during the antenatal period is necessary to take the appropriate measures. Complete blood count (CBC) and peripheral smear are routinely done investigations during antenatal check up. Red blood cell (RBC) indices like mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) can be used for initial screening, followed by electrophoresis for detecting these hemoglobinopathies. Aim: To determine the prevalence of hemoglobinopathies during antenatal period using red blood cell indices for screening. Materials and methodology: The study included 80 pregnant women whose CBC revealed MCV ≤ 80 fL, MCH ≤ 27 pg and microcytic hypochromic picture on peripheral smear. Hemoglobin electrophoresis was done to detect hemoglobinopathies. Results: Elevated HbA2 fraction (> 3.5%) was found in 5 (6.25%) women suggestive of β-thalassemia trait. HbA and HbS bands were present in 3 (3.75%) subjects suggestive of sickle cell trait. Conclusion: Red blood cell (RBC) indices, MCV and MCH, can be used for initial screening of hemoglobinopathies followed by more confirmatory methods (electrophoresis). Detection of these hemoglobin disorders in the carrier stage would thus be possible. Clinical significance: Simple screening methods can reduce the incidence of the most prevalent hemoglobinopathies (β-thalassemia trait and sickle cell trait/disease) during antenatal care.

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  1. Datar S, Poflee S, Shrikhande A. Premarital screening of college students for carrier detection in thalassemia and sickle cell disease: Need of the hour. International Journal of Medical Science And Public Health, 2015;4(3): 420-423.
  2. Mendiratta SL, Mittal M, Naaz F, Singh S, Anand S. Role of thalassemia screening in prevention and control of thalassemia - a 5 year experience. Int J Reprod Contracept Obstet Gynecol 2016;5:3107-11.
  3. Keshav Pagrut, Pratik Chide. Screening for the sickle cell gene in Yavatmal district, Maharashtra, India: An approach to a major health problem. International Journal of Biomedical and Advanced Research 2017; 8 (02):50-53.
  4. Balgir RS. A cross-sectional study of haemoglobin disorders in pregnant women attending to urban hospitals in eastern coast of Odisha, India. Online Journal of Health and Allied Sciences, Vol.12, Issue 4, Oct-Dec 2013.
  5. Jain BB, Roy RN, Ghosh S, Ghosh T, Banerjee U, Bhattacharya SK. Screening for thalassemia and other hemoglobinopathies in a tertiary care hospital of West Bengal: Implications for population screening. Indian J Public Health 2012; 56: 297-300.
  6. Hoffmann JJML, Urrechaga E, Aguirre U. Discriminant indices for distinguishing thalassemia and iron deficiency in patients with microcytic anemia: a meta-analysis. Clinical Chemistry and Laboratory Medicine (CCLM) [Internet]. Walter de Gruyter GmbH; 2015 Jan 1;53(12).
  7. Jameel T, Baig M et al. Differentiation of beta thalassemia trait from iron deficiency anemia by haematological indices. Pakistan Journal of Medical Sciences 2017;33(3):665-669.
  8. Vehapoglu A, Ozgurhan G, Demir AD, Uzuner S, Nursoy MA, Turkmen S, et al. Hematological Indices for Differential Diagnosis of Beta Thalassemia Trait and Iron Deficiency Anemia. Anemia [Internet]. Hindawi Limited; 2014;2014:1–7.
  9. Moafi A, Valian S, Nikyar Z, Zeinalian M, Momenzadeh M, Rahgozar S. Prevalence of minor -thalassemia based on RBC indices among final suspected individuals in premarital screening program referred to Genetic Laboratories. International Journal of Hematology Oncology and Stem cell research 2010 Jan;4(1):23-27.
  10. Ou Z, Li Q, Liu W, Sun X. Elevated Hemoglobin A2 as a Marker for -Thalassemia Trait in Pregnant Women. The Tohoku Journal of Experimental Medicine [Internet]. Tohoku University Medical Press; 2011;223(3):223–226.
  11. Baxi A, Manila K, Kadhi P, Heena B. Carrier Screening for â Thalassemia in Pregnant Indian Women: Experience at a Single Center in Madhya Pradesh. Indian Journal of Hematology & Blood Transfusion. 2013;29(2):71-74. doi:10.1007/ s12288-012-0165-8.
  12. Leung, TN, Lau TK, Chung TKH. Thalassaemia screening in pregnancy. Curr Opin Obstet Gynecol 2005;17:129-34.
  13. Philip J, Sarkar RS, Kushwaha N. Microcytic hypochromic anemia: Should high performance liquid chromatography be used routinely for screening anemic and antenatal patients?. Indian J Pathol Microbiol 2013; 56:109-13.
  14. Tangvarasittichai O, Poonanan N, Tangvarasittichai S. Using Red Cell Indices and Reticulocyte Parameters for Carrier Screening of Various Thalassemia Syndromes. Indian Journal of Clinical Biochemistry [Internet]. Springer Nature; 2016 May 9;32(1):61-67.
  15. Bhukhanvala DS, Sorathiya SM, Shah AP, Patel AG, Gupte SC. Prevalence and hematological profile of â-thalassemia and sickle cell anemia in four communities of Surat city. Indian Journal of Human Genetics. 2012;18(2):167-171.
  16. Mohanty D, Colah RB, Gorakshakar AC, et al. Prevalence of â-thalassemia and other haemoglobinopathies in six cities in India: a multicentre study. Journal of Community Genetics. 2013;4(1):33-42.
  17. Kumar R, Arya V, Agarwal S. Profiling Thalassemia Mutations in Consanguinity and Nonconsanguinity for Prenatal Screening and Awareness Programme. Advances in Hematology [Internet]. Hindawi Limited; 2015;2015:1–5.
  18. Galanello R. Screening and Diagnosis for Haemoglobin Disorders. In: Angastiniotis M, Eleftheriou A, Galanello Ret al., authors; Old J, editor. Prevention of Thalassaemias and Other Haemoglobin Disorders: Volume 1: Principles [Internet]. 2nd edition. Nicosia, Cyprus: Thalassaemia International Federation; 2013. Chapter 4.
  19. Bhalodia JN, Oza HV, Modi PJ, Shah AM, Patel KA, Patel HB. Study of Hemoglobinopathies in Patients of Anemia using High Performance Liquid Chromatography (HPLC) in Western India. Natl J Community Med. 2015;6(1): 35-40.on electrophoresis indicative of sickle cell trait. Figure 2 shows the HbA and HbS band on electrophoresis of a woman with sickle cell trait.
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