A reliable screening protocol for thalassemia and hemoglobinopathies in pregnancy: An alternative approach to electronic blood cell counting

Primary screening for thalassemia and hemoglobinopathies usually involves an accurate blood count using an expensive electronic blood cell counter A cheaper alternative method was tested by using a modified osmotic fragility (OF) test and a modified dichlorophenolindophenol (DCIP) test. Altogether 4...

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Bibliographic Details
Published in:American journal of clinical pathology 2005, Vol.123 (1), p.113-118
Main Authors: SANCHAISURIYA, Kanokwan, FUCHAROEN, Supan, FUCHAROEN, Goonnapa, RATANASIRI, Thawalwong, SANCHAISURIYA, Pattara, CHANGTRAKUL, Yossombat, UKOSANAKARN, Uthai, USSAWAPHARK, Wichai, SCHELP, Frank P
Format: Article
Language:English
Subjects:
Adult
Anemias. Hemoglobinopathies
Biological and medical sciences
Blood Cell Count - methods
Diseases of red blood cells
Electronics, Medical
Erythrocyte Indices
Female
Hematologic and hematopoietic diseases
Hemoglobinopathies - blood
Hemoglobinopathies - diagnosis
Humans
Investigative techniques, diagnostic techniques (general aspects)
Medical sciences
Osmotic Fragility
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Pregnancy
Pregnancy Complications, Hematologic - blood
Pregnancy Complications, Hematologic - diagnosis
Thalassemia - blood
Thalassemia - diagnosis
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Summary:Primary screening for thalassemia and hemoglobinopathies usually involves an accurate blood count using an expensive electronic blood cell counter A cheaper alternative method was tested by using a modified osmotic fragility (OF) test and a modified dichlorophenolindophenol (DCIP) test. Altogether 423 pregnant Thai women participated in this project. Hemoglobin patterns and globin genotypes were determined using an automated high-performance liquid chromatography analyzer and polymerase chain reaction analysis of alpha- and beta-globin genes. Among the 423 subjects, 264 (62.4%) carried thalassemia genes. The combined OF and DCIP tests detected all pregnant carriers of the 3 clinically important thalassemias, ie, alpha0-thalassemia, beta-thalassemia, and hemoglobin E with a sensitivity of 100.0%, specificity of 87.1%, positive predictive value of 84.5%, and negative predictive value of 100.0%, which show more effectiveness than these values for the standard method based on RBC counts. A combination of modified OF and DCIP tests should prove useful and applicable to prenatal screening programs for thalassemia and hemoglobinopathies in communities with limited facilities and economic resources.
ISSN:0002-9173
1943-7722
DOI:10.1309/FUF9EVGQ24V1PKTP