Differentiation of the β-thalassemia Trait from Iron Deficiency Anaemia by Red Cell Indices among Pregnant Women in Southern Haryana

Abstract

Introduction: Due to similar red cell morphology, patients of beta Thalassemia Trait (β-TT) are often misdiagnosed as Iron Deficiency Anaemia (IDA) and given unnecessary iron medication. Facilities for diagnosing them are usually not available in underserved areas where health system and laboratory facilities are not strengthened. Aim: To differentiate β-TT from IDA by red cell indices among pregnant women in Southern Haryana, India. Materials and Methods: This hospital-based, cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at Shaheed Hasan Khan Mewati Government Medical College, Haryana, India, from May 2020 to October 2020. Total 148 antenatal women were screened for presence of anaemia by their haemoglobin level at the time of admission. Types of anaemia were documented. After staining, it was examined for red cell morphology and various red cell indices were also noted. Data collected was entered in Microsoft excel 7, then data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0 software package. Results: Of total 148 pregnant women, 104 were found to be anaemic thus the overall prevalence of anaemia was found to be 70.27% (104/148). Most of pregnant women were in the age group of 18-24 years (54.8%). Microcytic hypochromic picture (38.4%), followed by normocytic hypochromic to microcytic hypochromic (20.1%) was predominant on Peripheral Blood Film (PBF) examination followed by dimorphic anaemia. Red Blood Cell (RBC) count was found to be normal in 85.5% cases followed by decreased count in 14.4% cases. None of the case had increased RBC count. Mean Corpuscular Volume (MCV) was normal in 58.6% of cases followed by decreased below 80 fL in 28.8% of cases. Conclusion: Higher prevalence of anaemia in pregnant women indicates that anaemia still continues to be a major health problem in India. In resource constrained settings, where definitive diagnostic facilities do not exist, red cell indices may be used to differentiate β-TT from IDA among pregnant women.