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Background and ObjectivesPregnancy in women with sickle cell disease (SCD) is associated with severe complications. Red blood cell (RBC) alloimmunisation is a worrying situation in pregnant women with SCD. This could increase the difficulty in finding a pheno‐compatible red blood product. Our study aimed to determine the prevalence of RBC alloantibodies in pregnant women with SCD and to determine the risk factors for alloantibodies formation.Methods/MaterialsWe conducted a prospective study at the “Centre National de Transfusion Sanguine de Bamako” from August 2022 to January 2023. For each participant, we collected important information, including obstetrical and transfusion histories. We performed ABO group, Rh and Kell phenotyping, and antibody screening in all study participants. We performed statistical analysis.ResultsWe recruited 95 pregnant women with SCD. In our study, 62% of our participant had a history of blood transfusion. Only 23% of our pregnant women with SCD had a history of miscarriage. The prevalence of RBC alloantibodies was 14%. The main antibodies detected were anti‐E (38%) and pan‐agglutinins (23%). Miscarriage history, blood transfusion history, and pregnancy number were the main risk factors for RBC alloimmunisation.ConclusionThe care of pregnant women with SCD is complex and requires collaboration between haematologists, clinicians and gynaecologists. National guidelines should be implemented to make ABO and D typing, Rh and Kell phenotyping and antibody screening routine for all pregnant women. This would facilitate early detection of high‐risk situations. Particular attention should be paid to SCD pregnant women with miscarriage and blood transfusion histories.
Background and ObjectivesPregnancy in women with sickle cell disease (SCD) is associated with severe complications. Red blood cell (RBC) alloimmunisation is a worrying situation in pregnant women with SCD. This could increase the difficulty in finding a pheno‐compatible red blood product. Our study aimed to determine the prevalence of RBC alloantibodies in pregnant women with SCD and to determine the risk factors for alloantibodies formation.Methods/MaterialsWe conducted a prospective study at the “Centre National de Transfusion Sanguine de Bamako” from August 2022 to January 2023. For each participant, we collected important information, including obstetrical and transfusion histories. We performed ABO group, Rh and Kell phenotyping, and antibody screening in all study participants. We performed statistical analysis.ResultsWe recruited 95 pregnant women with SCD. In our study, 62% of our participant had a history of blood transfusion. Only 23% of our pregnant women with SCD had a history of miscarriage. The prevalence of RBC alloantibodies was 14%. The main antibodies detected were anti‐E (38%) and pan‐agglutinins (23%). Miscarriage history, blood transfusion history, and pregnancy number were the main risk factors for RBC alloimmunisation.ConclusionThe care of pregnant women with SCD is complex and requires collaboration between haematologists, clinicians and gynaecologists. National guidelines should be implemented to make ABO and D typing, Rh and Kell phenotyping and antibody screening routine for all pregnant women. This would facilitate early detection of high‐risk situations. Particular attention should be paid to SCD pregnant women with miscarriage and blood transfusion histories.
Background and objectives The presence of red blood cell (RBC) alloantibodies in pregnant women has been linked to the significant perinatal morbidity and mortality. A limited number of African studies have assessed alloimmunization to RBC antigens in pregnant women, but this literature has not been systematically reviewed. Thus, the aim of this study was to synthetize, by systematic review, the current evidence on RBC alloantibodies among pregnant women in Africa. Methods We systematically searched MEDLINE, EMBASE and the Africa‐Wide Information database to identify relevant studies in any language. Case reports, comments, letters, conference abstracts, editorials and review articles were excluded. Results Of 269 potentially relevant articles, 12 studies representing 93 871 pregnant women fulfilled our selection criteria. Overall proportions of RBC alloimmunization exhibited a wide variation ranging from 1·1 (95% CI: 1·0, 1·2) to 12·1 (95% CI: 9·8, 14·7) per 100 pregnant women. Among clinically relevant antibodies, anti‐D ranked as the most common, followed by anti‐K and anti‐E. Conclusion The review of the available literature characterized the clinical challenge of RBC alloimmunization among pregnant women in Africa and revealed the insufficient volume and quality of research conducted in this topic. Improvement of quality of research should be a priority to gather stronger evidence that should drive policy decisions and strengthen practice in favour of RBC alloantibody screening in pregnant women as a standard of care throughout Africa.
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