The obstetric management of sickle cell disease

Best Pract Res Clin Obstet Gynaecol. 2012 Feb;26(1):25-36. doi: 10.1016/j.bpobgyn.2011.10.001. Epub 2011 Nov 22.

Abstract

Sickle cell disease (SCD) is the most common inherited disease worldwide and is associated with anaemia and intermittent severe pain. Pregnant women who are affected have increased maternal and fetal mortality and morbidity. In view of this obstetricians should have an awareness of this condition and its complications, and pregnancies in women with SCD should be managed by a multidisciplinary team with experience of high risk pregnancies. Ideally women should be seen preconceptually for optimisation of their SCD and partner screening. Antenatal care should include regular outpatient visits with regular monitoring for pre-eclampsia and of fetal growth. Blood transfusion should be used for the treatment of acute anaemia, acute chest syndrome or acute stroke but there is not sufficient evidence currently to recommend its use prophylactically. There is an increased prevalence of sickle crisis during pregnancy and patients should be monitored carefully throughout this time.

Publication types

  • Review

MeSH terms

  • Anemia, Sickle Cell / therapy*
  • Delivery, Obstetric
  • Female
  • Genetic Testing
  • Humans
  • Pain / drug therapy
  • Postnatal Care
  • Preconception Care*
  • Pregnancy
  • Pregnancy Complications, Hematologic / therapy*
  • Prenatal Care*