The pattern of sickle cell disease in pregnancy in Lagos, Nigeria

The outcome of pregnancy and labour in patients with sickle cell disease delivered at the Lagos University Teaching Hospital (LUTH) under one obstetrician between 1st January 1985 and 31st December, 1989 is analysed. There were 31 pregnancies in 28 patients with sickle cell anaemia (HbSS) and 10 pregnancies in seven patients with sickle cell haemoglobin C disease (HbSc). Six pregnancies in HbSS patients and two in HbSC were in patients who had not had specialized preconceptual care. There was one abortion in a patient with HbSC and one pair of twins in a patient with HbSS. The complication rate was high in HbSC patients as compared to a previous series but not as high as in patients with HbSS. The perinatal mortality rates were 233 and 111 per 1000 deliveries in HbSS and HbSC patients respectively. The maternal mortality rates were 129 and 111 per 1000 deliveries in HbSS and HbSC patients respectively. Two of the maternal deaths and four of the perinatal deaths occurred in HbSS patients who had had no preconceptual specialist care as opposed to those receiving specialist treatment. In the case of perinatal mortality, this was found to be statistically significant (p < 0.001).