Pregnancy in Sickle-Cell Anæmia

Pregnancy in sickle cell disease in the UK

“…Reports from Nigeria (Fullerton & Watson-Williams 1962;Hendrickse et al 1972) indicate a far worse maternal and *Present address: Senior Registrar, Department of Obstetrics, John Radcliffe Hospital, Headington, Oxford. 0306.545 6/83/0200-0 1 12%02.00 0 1983 British Journal of Obstetrics and Gynaecology 112 fetal outcome than the American experience (although improved by vigorous therapeutic measures), but, in contrast, the Jamaican (Anderson et al 1960) and Saudi Arabian (Perrine & John 1974;Pembrey et al 1978) reports indicate a more favourable course. It is generally assumed that the natural history of sickle cell disease in the UK follows the intermediate severity noted in the USA, though reports from this country of the effect of the disease on pregnancy have so far been limited to very small numbers (Diamond 1959;Apthorp et al 1963;Buckle 1968;Buckle et al 1969;Anionwu et al 1981).…”

Haemoglobinopathies in pregnancy

“…One of the major stumbling blocks to providing information of value to the obstetrician is the very variable severity of sickle-cell anaemia from one patient to another. Indeed, any child who survives until adolescence and, subsequently, becomes pregnant may in any case be at the milder end of the clinical spectrum of this disease process (Apthorp et al, 1963). In some cases, attenuating factors such as an unusually high level of fetal haemoglobin in the red cells (Charache and Conley, 1964) and the coexistence of cx thalassaemia, are known to lessen the severity of sickle-cell anaemia (van Enk et al, 1972).…”

Haemoglobinopathies in pregnancy

“…One of the major stumbling blocks to providing information of value to the obstetrician is the very variable severity of sickle-cell anaemia from one patient to another. Indeed, any child who survives until adolescence and, subsequently, becomes pregnant may in any case be at the milder end of the clinical spectrum of this disease process (Apthorp et al, 1963). In some cases, attenuating factors such as an unusually high level of fetal haemoglobin in the red cells (Charache and Conley, 1964) and the coexistence of cx thalassaemia, are known to lessen the severity of sickle-cell anaemia (van Enk et al, 1972).…”