Pregnancy in Pre- and Postsplenectomy Cases of Hereditary Spherocytosis

Ashish Kumar Mandal, Tajinder Singh, P. Ahuja, D-11/81, West Kidwai Nagar, New Delhi, 110023 (India) In a recent article in Acta Haematologica [72: 29-33 (1984)], a family with hereditary spherocytosis was described in which three sisters had delivered mature live infants without splenectomy. Dr. D.O. Ho-Yen had concluded that the majority of patients with hereditary spherocytosis in pregnancy should be managed expectantly. However, our experience is quite different. We had two patients who were examined for bad obstetric history and frequent attacks of jaundice. The first patient (S.B.) had one premature delivery and a stillbirth at the time of admission. The second patient (T.D.) had two miscarriages. Both patients were carefully examined and were diagnosed as having hereditary spherocytosis. Both of them underwent splenectomy. Later, T.D. delivered three live infants within 31⁄2 years two of whom are suffering from hereditary spherocytosis. S.B. has delivered one live male child. This child could not be investigated for hereditary spherocytosis. We believe that in cases of hereditary spherocytosis with bad obstetric history, splenectomy is indicated for a normal child birth. Reference 1 Ho-Yen, D.O.: Hereditary spherocytosis presenting in pregnancy 72: 29-33(1984).