Acute Chest Syndrome in Pregnant Women with Hemoglobin SC Disease

Nomura, Roseli Mieko Yamamoto; Igai, Ana Maria Kondo; Tosta, K.; Fonseca, Guilherme Henrique Hencklain; Gualandro, Sandra Fátima Menosi; Zugaib, Marcelo

doi:10.1590/s1807-59322009000900015

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…Moreover, previous studies have reported increased incidences of thromboembolism and pulmonary infarct, which are usually fatal, in pregnant women with Hb SS and SC hemoglobinopathies. 5 , 18 , 19 , 20 , 21 These complications might occur anytime during pregnancy, childbirth, or puerperium, but they are more common in the third trimester and in the puerperium. They even can be the first manifestation of the disease in previously oligosymptomatic patients, such as in pregnant women with Hb SC or Hb S/β + -thalassemia.…”

Section: Discussionmentioning

confidence: 99%

“…They even can be the first manifestation of the disease in previously oligosymptomatic patients, such as in pregnant women with Hb SC or Hb S/β + -thalassemia. 20 , 21 The risk of maternal death is higher during the third trimester and the puerperium, 22 probably due to variations in hormones, hypercoagulability and increased susceptibility to infections during these periods. 4 In the current study, one third of the pregnant women had pulmonary complications, which was the reason for four deaths due to acute respiratory failure, regardless of the treatment provided.…”

Section: Discussionmentioning

confidence: 99%

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Clinical complications in pregnant women with sickle cell disease: prospective study of factors predicting maternal death or near miss

Cardoso

Aguiar

Viana

2014

Revista Brasileira de Hematologia e Hemoterapia

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ObjectiveTo evaluate complications in pregnant women with sickle cell disease, especially those leading to maternal death or near miss (severe obstetric complications).MethodsA prospective cohort of 104 pregnant women registered in the Blood Center of Belo Horizonte (Hemominas Foundation) was followed up at high-risk prenatal units. They belonged to Group I (51 hemoglobin SS and three hemoglobin S/β0-thalassemia) or Group II (49 hemoglobin SC and one hemoglobin S/β+-thalassemia). Both groups had similar median ages. Predictive factors for ‘near miss’ or maternal death with p-value ≤ 0.25 in the univariate analysis were included in a multivariate logistic model (significance set for p-value ≤ 0.05).ResultsGroup I had more frequent episodes of vaso-occlusive crises, more transfusions in the antepartum and postpartum, and higher percentage of preterm deliveries than Group II. Infections and painful crises during the postpartum period were similar in both the groups. The mortality rate was 4.8%: three deaths in Group I and two in Group II. One-third of the women in both the groups experienced near miss. The most frequent event was pneumonia/acute chest syndrome. Alpha-thalassemia co-inheritance and β-gene haplotypes were not associated with near miss or maternal death. In multivariate analysis predictors of near miss or death were parity above one and baseline red blood cell macrocytosis. In Group I, baseline hypoxemia (saturation < 94%) was also predictive of near miss or death.ConclusionOne-third of pregnant women had near miss and 4.8% died. Both hemoglobin SS and SC pregnant women shared the same risk of death or of severe complications, especially pulmonary events.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical complications in pregnant women with sickle cell disease: prospective study of factors predicting maternal death or near miss

Cardoso

Aguiar

Viana

2014

Revista Brasileira de Hematologia e Hemoterapia

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“…While all these complications are not specific to pregnancy in women with SCD, they are more frequent and are exacerbated during pregnancy and are all major causes of severe ill health and death among women with the condition. Although the complications could arise in all forms of SCD, they are more frequent and severe among those with sickle cell anaemia (HbSS) (Nomura 2009;Odum 2002; RCOG 2011).…”

Section: Description Of the Conditionmentioning

confidence: 99%

Prophylactic versus selective blood transfusion for sickle cell disease in pregnancy

Okusanya

Oladapo

2016

Cochrane Database of Systematic Reviews

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“…While incidence of this serious complication in pregnancy is estimated to be only 0.06% among all deliveries to women with SCD [15], case reports detail the significant risk that this condition imparts upon both mother and fetus [16,17]. Pregnancy can exacerbate anemia, increased infection risk, and the pro-coagulant state that are preexisting in pregnancy [18].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Complications of Sickle Cell Disease in the Pregnant Patient

Lazo¹

2017

Int J Respir Pulm Med

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Respiratory complaints are common symptoms in pregnancy, and it is important to delineate whether the causative factor is cardiac, pulmonary, or physiologic in origin. The pathophysiology of Sickle Cell Disease (SCD) can further complicate the differential diagnosis. To our knowledge, there is little to no literature devoted to the management of pulmonary complications in the pregnant sickle cell patient. Therefore we present a review of the current literature and feature reports on the incidence and prevalence of the pulmonary complications in a sickle cell pregnancy. These include Acute Chest Syndrome (ACS), Pulmonary Hypertension (PH), Pulmonary Embolism (PE), and sickle cell chronic lung disease. We also aim to recommend management strategies that address the SCD-related pulmonary complications in the pregnant state.

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Acute Chest Syndrome in Pregnant Women with Hemoglobin SC Disease

Cited by 6 publications

References 7 publications

Clinical complications in pregnant women with sickle cell disease: prospective study of factors predicting maternal death or near miss

Clinical complications in pregnant women with sickle cell disease: prospective study of factors predicting maternal death or near miss

Prophylactic versus selective blood transfusion for sickle cell disease in pregnancy

Pulmonary Complications of Sickle Cell Disease in the Pregnant Patient

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