Pregnancy in Sickle Cell Disease Is a Very High-Risk Situation: An Observational Study.

Narcisse Elenga,Laetitia Accrombessi,Gabriel Carles,John Balcaen,Anne Terraz,Mélanie Calvez,Tania Vaz,Aurélie Adeline

doi:10.1155/2016/9069054

Narcisse Elenga, Laetitia Accrombessi + Show 6 more

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https://doi.org/10.1155/2016/9069054

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Abstract

Sickle cell disease is a serious genetic disorder affecting 1/235 births in French Guiana. This study aimed to describe the follow-up of pregnancies among sickle cell disease patients in Cayenne Hospital, in order to highlight the most reported complications. 62 records of pregnancies were analyzed among 44 females with sickle cell disease, between 2007 and 2013. Our results were compared to those of studies conducted in Brazil and Guadeloupe. There were 61 monofetal pregnancies and 2 twin pregnancies, 27 pregnancies among women with SS phenotype, 30 SC pregnancies, and five S-beta pregnancies. The study showed that the follow-up of patients was variable, but no maternal death was found. We also noted that the main maternofetal complications of pregnancies were anemia (36.5%), infection (31.7%), vasoocclusive crisis (20.6%), preeclampsia (17.5%), premature birth (11.1%), intrauterine growth retardation (15.9%), abnormal fetal heart rate (14.3%), and intrauterine fetal death (4.8%). Pregnancies were more at risk among women with SS phenotype. Pregnancy in sickle cell disease patients requires a supported multidisciplinary team including the primary care physician, the obstetrician, and the Integrated Center for Sickle Cell Disease.

Highlights

Sickle cell disease is the most common inherited disorder worldwide with varying clinical severity and potentially serious complications [1]
This study aimed to describe the followup of pregnancies among sickle cell disease patients in Cayenne Hospital, in order to highlight the most reported complications. 62 records of pregnancies were analyzed among 44 females with sickle cell disease, between 2007 and 2013
We noted that the main maternofetal complications of pregnancies were anemia (36.5%), infection (31.7%), vasoocclusive crisis (20.6%), preeclampsia (17.5%), premature birth (11.1%), intrauterine growth retardation (15.9%), abnormal fetal heart rate (14.3%), and intrauterine fetal death (4.8%)

Summary

Introduction

Sickle cell disease is the most common inherited disorder worldwide with varying clinical severity and potentially serious complications [1]. Oteng-Ntim et al [8], in a systematic review and meta-analysis of previous observational studies, have quantified this risk. They showed that women with SCD have an increased risk of preeclampsia and maternal death, stillbirths, preterm deliveries, and smallfor-gestational-age newborns. Knowledge of these risks has contributed to the implementation of a multidisciplinary management program including the early detection and treatment of complications during pregnancy and postpartum, follow-up by an obstetric team and a sickle cell team, appropriate pain management protocols, and transfusion programs adapted to each pregnant patient

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