[Sickle cell disease and pregnancy].

Area of Science:

• Hematology
• Obstetrics & Gynecology
• Maternal-Fetal Medicine

Context:

• Pregnancy in women with sickle cell disease (SCD) is a high-risk condition.
• Increased incidence of maternal and fetal morbidity and mortality, particularly in late pregnancy, delivery, and postpartum periods.
• SCD exacerbates complications like anemia, vaso-occlusive crisis, thrombosis, infections, and toxemia.

Purpose:

• To highlight the increased risks associated with pregnancy in women with sickle cell disease.
• To emphasize the importance of specialized management programs for optimizing pregnancy outcomes.
• To underscore the need for a multidisciplinary approach in tertiary maternal health services.

Summary:

• Pregnancy in women with major sickle cell syndrome significantly raises risks of maternal and fetal complications, including anemia, vaso-occlusive crisis, thrombosis, infections, and toxemia.
• SCD is linked to high rates of spontaneous abortion, intrauterine growth retardation, fetal death, preterm delivery, and perinatal mortality.
• Despite normal fertility, increased risks necessitate specialized management programs involving multidisciplinary teams and tertiary care.

Impact:

• Implementation of specific management programs has led to better pregnancy outcomes for women with SCD.
• A close, multidisciplinary approach throughout pregnancy, delivery, and postpartum care is essential.
• Blood transfusions are reserved for strictly defined maternal, obstetrical, and hematologic indications.