Outcome of pregnancy in sickle cell disease patients attending a combined obstetric and haematology clinic

Yu, Christina; Stasiowska, E.; Stephens, A. D.; Awogbade, Moji; Davies, Anthony

doi:10.1080/01443610903003175

Cited by 33 publications

(29 citation statements)

References 24 publications

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“…In the literature, acute pain crisis and acute anemia are the most important maternal complications in terms of frequency, findings that are consistent with our study. The efficacy of prophylactic transfusion on acute pain crisis reduction has been recognized .…”

Section: Discussionsupporting

confidence: 93%

Transfusion practices in the care of pregnant women with sickle cell disease in Ouagadougou

Zamané

Sanou

Kiemtoré

et al. 2019

Intl J Gynecology & Obste

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Objective To study the contribution of blood transfusion management in the improvement of maternal and perinatal outcomes in pregnant women with sickle cell disease in Ouagadougou. Methods A cross‐sectional retrospective study with data collected from February 2012 to January 2014 was used. Patients were differentiated into three groups: patients with at least one exchange transfusion, patients who received blood transfusion, and patients who did not receive any transfusion. Data were collected from patients’ patient care documents. Results One hundred and sixty‐four patients were included, of whom 53 were in the first group, 32 in the second group, and 79 in the third group. Maternal complications in the last trimester of pregnancy were significantly less important (P=0.000) in the first group (58.5%) than in the second (78.5%) and third group (91.1%). The same trend was observed for postpartum maternal mortality (5.7%; 12.5%; 12.6%; P=0.009). Fetal complications such as preterm birth and early neonatal death were lower in the first group (15.1%; 1.8%) than in the second (40.6%; 23.1%) and third group (32.9%; 7.6%). Conclusion Prophylactic blood transfusion is an important part of the management of pregnant patients with sickle cell disease.

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Section: Discussionsupporting

confidence: 93%

Transfusion practices in the care of pregnant women with sickle cell disease in Ouagadougou

Zamané

Sanou

Kiemtoré

et al. 2019

Intl J Gynecology & Obste

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“…27,29 Reduced oxygen content of blood in maternal anemia can affect placental perfusion and thereby increase the risk of IUGR. 30 We did not observe associated risk of IUFD among HbSS women. One explanation could be improved fetal monitoring and the increased likelihood of interventions.…”

mentioning

confidence: 71%

“…Anemia is one of the major complications of sickle cell disease and may be caused by hemolysis or trapping of the red blood cells in the spleen. 30 Anemia in pregnancy has been found to be associated with increased risk for PROM, spontaneous preterm labor, preterm delivery, poor intrauterine growth, and LBW infants, [32][33][34][35][36][37][38] which in turn results in higher perinatal morbidity and mortality, and a higher infant mortality rate.…”

mentioning

confidence: 99%

Pregnancy Outcomes among Patients with Sickle Cell Disease at Korle-Bu Teaching Hospital, Accra, Ghana: Retrospective Cohort Study

Wilson

Ceesay²,

Hibbert³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. Pregnancy in sickle cell disease (SCD) patients is associated with increased risk of maternal and fetal mortality. This study determines pregnancy outcomes among women with SCD delivering at Korle-Bu Teaching Hospital, Accra, Ghana. Nine hundred sixty (960) medical records of pregnant women (131 HbSS, 112 HbSC, and 717 comparison group) from 2007 to 2008 were reviewed. The HbSS women were at increased risk of eclampsia (adjusted odds ratio [AOR] = 10.56, 95% confidence interval [CI] = 3.60-30.96, P 0.001), intrauterine growth restriction (AOR = 4.00, 95% CI = 1.38-11.64, P = 0.011), and placenta previa (AOR = 22.03, 95% CI = 9.87-49.14, P 0.001) compared with the comparison group. The HbSC women had increased risk for intrauterine fetal death (AOR = 3.38, 95% CI = 1.15-9.96, P = 0.027) and decreased risk of delivering low birth weight babies (AOR = 0.21, 95% CI = 0.06-0.73, P = 0.014). Women with SCD in Ghana are at a greater risk of morbidity and mortality in pregnancy compared with women without hemoglobinopathies. Improved maternal and fetal outcomes in Ghanaian women with SCD can be achieved through effective intervention by health care providers with thorough knowledge about predisposing factors toward adverse outcomes.

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“…Pregnancies in sickle cell disease (SCD) have, in some respects, shown worsening outcomes over time,3 4 though not, apparently, in some recent single-hospital series 5 6 7

Methods

We ascertained outcomes of 206 pregnancies complicated by SCD from 11 hospitals in the UK over the period 2000 to 2004.

…”

mentioning

confidence: 99%

Pregnancy outcome in sickle cell disease in the UK: have things changed over three decades?

Rantell

Ashokkumar

et al. 2012

Arch Dis Child Fetal Neonatal Ed

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Sickle cell disease prevalence, albeit low, is increasing in the United Kingdom, from estimates of 5,000 in 1986 to 12,000 in 2010.1 2 Pregnancies in sickle cell disease (SCD) have, in some respects, shown worsening outcomes over time,3 4 though not, apparently, in some recent single-hospital series.5 6 7 Methods We ascertained outcomes of 206 pregnancies complicated by SCD from 11 hospitals in the UK over the period 2000 to 2004. Trend analysis compared these data with data from two previous surveys covering the 1980s and 1990s, using Z scores to assess trends in mortality rates, and the chi-square test for trends in complication rates. Results The perinatal mortality increased from 48 per 1000 in the first survey to 68 per 1000 in the latest survey. However, maternal mortality decreased by 3% (95% CI -1% to 7%), from 3.3% to 0.48% There was significant decline in severe sickle cell crises, pulmonary complications and urinary tract infections, but no reduction in severe pre-eclampsia. There was a significant decline in the use of blood transfusions in pregnancy over this time and significant increases in maternal age and in delivery by emergency caesarean section. Discussion While the UK perinatal mortality rate has fallen since 1980, that in SCD pregnancies has risen, with the rate now 9 times the national rate (68 compared with 7.6 per 1,000) Though our 2000 to 2004 survey ascertained one maternal death, CMACE reported 4 deaths during this period, indicating a continuing high maternal mortality in SCD in the UK.8

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Outcome of pregnancy in sickle cell disease patients attending a combined obstetric and haematology clinic

Cited by 33 publications

References 24 publications

Transfusion practices in the care of pregnant women with sickle cell disease in Ouagadougou

Transfusion practices in the care of pregnant women with sickle cell disease in Ouagadougou

Pregnancy Outcomes among Patients with Sickle Cell Disease at Korle-Bu Teaching Hospital, Accra, Ghana: Retrospective Cohort Study

Pregnancy outcome in sickle cell disease in the UK: have things changed over three decades?

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