Peripartum considerations in sickle cell disease

Area of Science:

• Hematology
• Obstetrics
• Genetics

Background:

• Pregnancy significantly worsens sickle cell disease (SCD), increasing maternal and fetal risks.
• High morbidity and mortality rates are associated with SCD in pregnancy.

Purpose of the Study:

• To review recent recommendations for managing sickle cell disease (SCD) in pregnant patients.
• To highlight updated pathobiological models and management strategies for SCD during pregnancy.

Main Methods:

• Review of recent literature and guidelines on sickle cell disease management in pregnancy.
• Analysis of updated pathobiological models of SCD.

Main Results:

• An updated pathobiological model identifies four key cellular disturbances in SCD.
• Red blood cell transfusions are a primary intervention but have drawbacks.
• New transfusion guidelines from the American Society of Hematology offer support for care providers.

Conclusions:

• Management necessitates a multidisciplinary team with expertise in SCD and pregnancy.
• Anesthetic management during the perioperative period is critical for mitigating disease exacerbation and improving outcomes.