Pregnancy in sickle cell disease in the UK

The complications and outcome of 125 pregnancies in women with sickle cell disease between 1975 and 1981 are reviewed. There were no maternal deaths, but a perinatal mortality rate of 48 per 1000. The main maternal complications were sickling crises (38%), anaemia (65%), infections (61%) and severe pregnancy-induced hypertensive disease (5%). There were three patients with eclampsia. There was a 13% spontaneous preterm delivery rate, 25% of the babies were 'light-for-dates', fetal distress in labour was seen in 24% and 15% were delivered by caesarean section. There was an increased incidence of involuntary infertility and spontaneous abortion. The treatment by prophylactic blood transfusions is discussed.