Thalassemia in pregnancy is best described as:

• A. Acquired iron overload
• B. Inherited inability to produce sufficient hemoglobin
• C. Autoimmune hemolysis
• D. Vitamin deficiency anemia

Answer: (B)

Thalassemia is a hereditary disorder of hemoglobin synthesis, caused by mutations that reduce or abolish production of one of the globin chains. In pregnancy, this is best described as an inherited inability to produce sufficient hemoglobin, since the problem is genetic and leads to chronic anemia from impaired globin production. The condition is typically autosomal recessive, so if both parents are carriers there is a risk to the fetus of being affected. This distinguishes thalassemia from the other options: it is not an acquired iron overload, not autoimmune destruction of red cells, and not due to vitamin deficiencies.