Pregnancy complicated by sickle hemoglobinopathy

During the last decade it has been shown that patients with major sickle hemoglobinopathies can experience a normal reproductive outcome. This has been accomplished with early aggressive prenatal care, effective counseling, and appropriate intervention by providers with a high index of suspicion for factors that lead to untoward outcomes in such women. Because controversy surrounds the use of transfusion therapy for pregnant patients with sickle cell disease, individualization should depend on patient circumstances and provider experience because this is a key factor in the management of these women. New therapies for those with major sickle hemoglobinopathy are on the horizon, but their use in pregnancy awaits further evaluation.