P358 Low Apgar's score at first minute and maternal platelet count in pregnancies complicated by sickle cell disease

Main Complications during Pregnancy and Recommendations for Adequate Antenatal Care in Sickle Cell Disease: A Literature Review

“…Fetal complications include FGR, low birth weight (LBW), prematurity, fetal distress during labor, and increased perinatal mortality. 10 14 15 22 27 However, there is a great deal of variation among published reports regarding the incidence of complications due to different study designs, country or world region of the studied cases, access to healthcare, and even the absence of statistical analysis to account for confounding variables. 12 A meta-analysis published in 2015 10 compared maternal and perinatal outcomes among women with and without SCD.…”

“…Neonatal death and premature birth were twofold higher in the HbSS group only, and small for gestational age babies were more prevalent among SCD women than among the control group. 10 A 2010 study 27 on mortality in SCD and the use of hydroxyurea (the first drug approved to treat SCD by increasing fetal hemoglobin production) showed a reduction in SCD complications such as painful episodes, blood transfusion, and acute chest syndrome, increasing the chance of patient survival from 65% to 86% in the from 65% to 86% in the treated group. 27 Although hydroxyurea is not approved for use in pregnancy, its use may be considered after pregnancy and breastfeeding in order to improve quality of life and reduce hospitalizations.…”

“… 10 A 2010 study 27 on mortality in SCD and the use of hydroxyurea (the first drug approved to treat SCD by increasing fetal hemoglobin production) showed a reduction in SCD complications such as painful episodes, blood transfusion, and acute chest syndrome, increasing the chance of patient survival from 65% to 86% in the from 65% to 86% in the treated group. 27 Although hydroxyurea is not approved for use in pregnancy, its use may be considered after pregnancy and breastfeeding in order to improve quality of life and reduce hospitalizations. Another study, 28 published in 2018, which evaluated adverse outcomes among patients with different SCD genotypes (HbSS, HbSC, and HbSβ thalassemia), included 89 women and found that 52% were hospitalized during pregnancy for clinical or obstetrical complications.…”

“… 33 34 About a third of SCD pregnant women face a near miss event during pregnancy or the puerperal cycle, especially due to acute chest syndrome, a severe form of VOC affecting the lungs, and the leading cause of death in adult SCD patients. 27 35 Unsurprisingly, SCD increases the possibility that a woman will experience a near miss event during pregnancy and/or the postpartum period. Despite the acute maternal severity of a near miss condition, this event is also associated with LBW and very low birth weight newborns, newborn admission to intensive care, stillbirth, early neonatal death, and long maternal hospital stays.…”

Maternal malnutrition during pregnancy among women with sickle cell disease

“…Of the other SCD variants, the most common is SC hemoglobinopathy (HbSC). Several studies have reported maternal and fetal complications in pregnant women with SCD: perinatal mortality, preterm labor, fetal growth restriction, preeclampsia, acute painful crises, and urinary and pulmonary infections 1 - 4 .…”