Sickle cell disease in pregnancy

Oteng‐Ntim, Eugene; Chase, A R; Howard, Jo; Khazaezadeh, Nina; Anionwu, Elizabeth

doi:10.1016/j.ogrm.2008.08.001

Cited by 14 publications

(3 citation statements)

References 30 publications

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“…1 It is well established that SCD in pregnancy is associated with an increase in maternal and fetal complications. 2,3 Maternal complications include preeclampsia, increased vaso-occlusive crises, thromboembolism and maternal death. 4 Fetal complications include increased rates of preterm delivery, intrauterine growth restriction (IUGR) and perinatal mortality.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes in sickle cell disease: a retrospective cohort study from two tertiary centres in the UK

et al. 2010

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The objective of this retrospective cohort study from two tertiary centres in the UK was to describe the pregnancy outcomes of women with sickle cell disease (SCD) who booked at these centres between 2004 and 2008, and to compare this with historical data. The study population comprised 122 singleton pregnancies in women with SCD: homozygous sickle cell disease 64, sickle cell haemoglobin C disease 45, sickle b plus thalassaemia 11, sickle cell haemoglobin E disease 1 and sickle cell delta disease 1 from 2004 to 2008 managed in the joint haematology/obstetric antenatal clinics in two tertiary teaching hospitals. The main outcome measures were the frequency of sickle cell crises and obstetric complications. Age and gestation at booking were 18-43 years (mean 29.7) and 9-36 weeks gestation (mean 17.3), respectively. Complications of SCD occurred in 25% of pregnancies. Fifty-four percent of women had induction of labour and 39% were delivered by emergency caesarean section. Thirty-three percent had a postpartum haemorrhage. Nineteen percent of women delivered before 37 completed weeks. Birth weight below 2500 g occurred in 20% of singleton pregnancies. Three neonates developed transient complications related to maternal opiate exposure postnatally. Three intrauterine deaths occurred at 24, 29 and 34 weeks. Two of these had congenital defects, and the other severe intrauterine growth restriction. No maternal deaths occurred. Successful pregnancy outcomes can be achieved in SCD. There has been an improvement in fetal and maternal morbidity and mortality compared with historical data. Pregnancy in women with SCD remains high risk. Early access to antenatal care and to expertise in SCD is essential. A matched control population from the same time period and prospective data collection is needed to address confounders such as ethnicity and deprivation.

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Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes in sickle cell disease: a retrospective cohort study from two tertiary centres in the UK

et al. 2010

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“…In the present study, preeclampsia was seen in 11% of the AS group and 16% of the SS group. Many authors have recorded a higher prevalence of preeclampsia in women with HbSS than in normal control [54][55][56][57][58]. The risk of preeclampsia is higher in women with HbSS than in women with HbAS.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Sickle Cell Hemoglobinopathy on Pregnancy, Labor, Puerperium, and Fetal Outcome: A Retrospective Cohort Study From a Single Centre

Atreja¹,

Mujalda²,

Mujalda³

et al. 2023

Cureus

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Introduction: Sickle cell disease (SCD) is a major risk factor as far as pregnancy and obstetric complications are concerned. It possesses major perinatal and postnatal mortality. The management of pregnancy along with SCD requires a multispecialty team consisting of hematologists, obstetricians, anesthesiologists, neonatologists and intensivists.Objectives: The objective of this study was to investigate the effect of sickle cell hemoglobinopathy on pregnancy, labor, puerperium, and fetal outcome in the rural and urban localities of Maharashtra, India.Material and methods: The present study is a comparative retrospective analysis of 225 pregnant women with SCD (genotype AS and SS) and 100 age-and gravida-matched pregnant women with normal hemoglobin (genotype AA) as a control who were treated between June 2013 to June 2015, in Indira Gandhi Government Medical College (IGGMC), Nagpur, India. We analyzed various data regarding obstetrical outcomes and complications in sickle cell disease mothers.Results: Out of 225 pregnant women, 38 (16.89%) were diagnosed with homozygous sickle cell disease (SS group) while 187 (83.11%) were diagnosed with sickle cell trait (AS group). The most common antenatal complications were sickle cell crisis (17; 44.74%) and jaundice (15; 39.47%) in the SS group whereas pregnancy-induced hypertension (PIH) was noted in 33 (17.65%) in the AS group. Intrauterine growth restriction (IUGR) was recorded in 57.89% of the SS group and 21.39% of the AS group. A higher chance of emergency lower segment cesarean section (LSCS; 66.67% in the SS group and 79.09% in the AS group) was recorded as compared with the control group at 32%. Conclusion:In order to minimize risks to the mother and fetus and for better outcomes it is prudent to manage pregnancy with SCD vigilantly in the antenatal period. In the antenatal period mothers with this disease should be screened for hydrops or bleeding manifestations such as intracerebral hemorrhage in the fetus. Better feto-maternal outcomes can be achieved by effective multispecialty intervention.

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“…La surveillance du post-partum précoce sera mieux réalisée en unité de surveillance continue et l'analgésie sera poursuivie. Une prophylaxie anti-thrombotique est indiquée [1,5,8]. Concernant la place d'une stratégie transfusionnelle, il existe un consensus sur l'indication ponctuelle de transfusions simples ou d'échanges érythrocytaires en cas d'anémie sévère, de crise douloureuse ne cédant pas aux antalgiques, de complications vaso-occlusives graves, d'insuffisance rénale aiguë, d'infection sévère ou de complication obstétricale.…”

Section: Discussionunclassified

Sickle cell disease SC in pregnancy: a case report

BENCHAKROUNE¹,

Moukit²,

Kouach³

et al. 2019

Batna J Med Sci

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La drépanocytose SC constitue le second des syndromes drépanocytaires majeurs. La grossesse chez cette catégorie de la population est associée à une morbi-mortalité materno-foetale élevée. Nous présentons un cas de grossesse chez une femme drépanocytaire hétérozygote composite SC compliquée de pré-éclampsie sévère avec mort foetale in utero et décès maternel dans un tableau de syndrome thoracique aigu. L’évolution fatale montre parfaitement le caractère gravissime de cette pathologie et l'importance d'une prise en charge multidisciplinaire.

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Sickle cell disease in pregnancy

Cited by 14 publications

References 30 publications

Pregnancy outcomes in sickle cell disease: a retrospective cohort study from two tertiary centres in the UK

Pregnancy outcomes in sickle cell disease: a retrospective cohort study from two tertiary centres in the UK

The Effect of Sickle Cell Hemoglobinopathy on Pregnancy, Labor, Puerperium, and Fetal Outcome: A Retrospective Cohort Study From a Single Centre

Sickle cell disease SC in pregnancy: a case report

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