Abstract
Background: A prospective, observational case control study to compare outcome of pregnancy in women with sickle cell disease (SCD) to normal haemoglobin.
Methods: All pregnant women with sickle cell disease who attended department of obstetrics and gynecology, Pt JNM medical college, Raipur were included in study. Age matched controls were included who had normal haemoglobin, in ratio 1:2. A detailed history was taken. All women were thoroughly examined and were properly followed and managed for any developing complications. Mothers were regularly screened for any developing medical/ obstetric complications throughout pregnancy, during delivery and in postpartum period till the discharge. The fetomaternal outcomes were compared using P value and paired T test whichever was suitable.
Results: Significant number of patients with SCD developed crisis, leg ulcers, AVN hip. Incidence of UTI, pneumonia, anemia, IUGR, severe oligohydramnios, preterm labor, post delivery wound infection were statistically significantly higher among cases as compared to controls. Requirement of blood transfusion, need of ventilatory support, duration of hospital stay, requirement of nursery admission for newborn was higher in cases as compared to controls.
Conclusion: Early booking, meticulous antenatal care and supervised hospital delivery will improve the maternal and fetal outcomes in the pregnant women with sickle cell disease.
Keywords: sickle cell disease, fetomaternal outcome, crisis, blood transfusion, Hb electrophoresis.
References
- Rees DC, Williams TN, Gladwin MT. Sickle-cell disease. Lancet. 2010;376 (9757):2018–2031. doi: 10.1016/S0140-6736(10)61029-X.
- Weatherall D. The inherited disorders of haemoglobin: an increasingly neglected global health burden. Indian J Med Res. 2011;134(4):493. [PMC free article] [PubMed]
- Sickle Cell Institute Chhattisgarh (SCIC), Raipur.
- Koshy M, Burd L. Management of pregnancy in sickle cellsyndromes. Hematol Oncol Clin North Am. 1991;5(3):585–96.8
- Serjeant GR, Loy LL, Crowther M, Hambleton IR, Thame M. Outcome of pregnancy in homozygous sickle cell disease. Obstet Gynecol. 2004;103(6): 1278–1285. doi: 10.1097/01. AOG.0000127433.23611.54.[PubMed] [Cross Ref
- Centre de Reference Maladies rareslabellisées (2007) Syndrome drépanocytaire majeur. Recommandations pour la prise en charge de la grossesse chez les femmesatteintes d’un syndrome drépanocytaire majeur.
- Centre de Reference Maladies rareslabellisées (2007) Syndrome drépanocytairemajeur. Recommendations pour la prise en charge de la grossesse chez les femmesatteintes d’un syndrome drépanocytaire majeur.
- Platt OS, Brambilla DJ, Rosse WF, Milner PF, Castro O, Steinberg MH, Klug PP. Mortality in sickle cell disease. Life expectancy and risk factors for early death. N Engl J Med 1994;330:1639–1644 [PubMed]
- Nomura R, Igai A, Tosta K, Fonseca G, Gualandro S, Zugaib M. Resultados maternos e perinatais emgestações complicadas pordoenças falciformes. Revista Brasileira de Geofísica. 2010;32(8).
- Muganyizi P, Kidanto H. Sickle Cell Disease in Pregnancy: Trend and Pregnancy Outcomes at a Tertiary Hospital in Tanzania.PLoS ONE 2013;8(2):e56541.
- Al Jama F, Gasem T, Burshaid S, Rahman J, Al Suleiman S, Rahman M. Pregnancy outcome in patients with homozygous sickle cell disease in a university hospital, Eastern Saudi Arabia. Archives of Gynecology and Obstetrics. 2009;280(5): 793-797.
- Nomura R, Igai A, Tosta K, Fonseca G, Gualandro S, Zugaib M. Resultados maternos e perinataisemgestações complicadaspor doenças falciformes. Revista Brasileira de Geofísica. 2010;32(8).
- Silva-Pinto A, de Oliveira DominguesLadeira S, Brunetta D, De Santis G, de LucenaAngulo I, Covas D. Sickle cell disease and pregnancy: analysis of 34 patients followed at the Regional Blood Center of RibeirãoPreto, Brazil. RevistaBrasileira de Hematologia e Hemoterapia. 2014;36(5):329-333.
- Oteng-Ntim E, Meeks D, Seed PT, Webster L, Howard J, Doyle P, et al. Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis. Blood. 2015;125:3316-25.
- Khandale S, Kedar K. A Study Of Sickle Cell Trait Complications In Pregnancy & Delivery At Tertiary Level Center. Journal of Evolution of Medical and Dental Sciences. 2015;04(11):1831-1835.
- SonawneA, Zodpey S. pregnancy outcome in women with sickle cell disease / trait. J Obste tGynocol India. 2005;vol. 55(No 5):415-418.
- Allen LH.Anemia and iron deficiency: effects on pregnancy outcome. Am J ClinNutr. 2000;71:1280S–1284S. [PubMed]
- Patel M, Shrivastava A, Desai D. Perinatal outcome in women with sickle cell disease/trait. Global Journal For Research Analysis. 2014;3(12):2277- 8160.
- Anyaegbunam A, Mikhail M, Axioitis C, Morel MI, Merkatz IR. Placental histology and placental/fetal weight ratios in pregnant women with sickle cell disease: relationship to pregnancy outcome. J Assoc Academic Minority Physicians. 1994;5(3):123-125.
- Kahansim ML et al. pregnancy outcome among patients with sickle cell disease in jos, north central nigeria. Jos Journal of Medicine. 2014;8(3):9-13.
Corresponding Author
Dr Akanksha Girish Mahajan MD (OBGY), CIMP
DOI: https://dx.doi.org/10.18535/jmscr/v7i11.32
