Pregnancy in sickle cell disease in Bahrain

Abstract

Objective To review the maternal and fetal complications in pregnant women with sickle cell disease and to compare their pregnancy outcome with those of controls. Design A case‐control study. Setting Ministry of Health hospitals in Bahrain. Subjects 147 pregnancies in 140 women with sickle cell disease and 294 controls matched for age and parity Main outcome measures The characteristics of women who had crises, the frequency of the crises, hypertensive disorders of pregnancy, infection, diabetes, perinatal mortality and the delivery statisties in the index and control women. Results Maternal mortality was 1.4% and perinatal mortality was 73.3/1000 total births in women with sickle cell disease, there were no maternal deaths and the perinatal mortality was 6.8/1000 births in the control group. Anaemia was treated by blood transfusion in 47% of women with sickle cell disease and, of these, 39% had a crisis that appeared to have been precipitated by the transfusion in the absence of any other predisposing factors. The presence of raised HbF did not decrease the number of crises but reduced their severity. Conclusion Pregnancy in women with sickle cell disease should be monitored very closely as it constitutes a high risk to both the mother and the baby.

Sickle cell disease in Middle East Arab countries

“…In a study conducted during the 1986 on Bahrani girls, the incidence of sickle cell haemoglobin (Hb AS), was approximately 7 per cent30. In a group of 100 consecutive pregnant females, the frequency of HbSC was 17.5 per cent, and Hb AS was 32.5 per cent31. Patients with SCD were shown to have elevated Hb F levels, and double heterozygous HbS/β-thalassaemia cases were also identified32.…”

Morbidity and mortality in sickle cell pregnancies in Lagos, Nigeria: A case control study

“…In Nigeria, about 25% of the population carries the sickle cell trait and approximately 100,000 children are born annually with a serious sickle cell disorder (WHO 1994). Although maternal and perinatal mortality has recently been reported to be reduced for women with SCD (Smith et al 1996;Mou Sun et al 2001), they are still prone to several complications during pregnancy including anaemia, severe crises, pulmonary disease and infections (El-Shafei et al 1992;Howard 1996;Ladwig et al 2000). Perinatal mortality rates are also higher than those for their haemoglobin AA counterparts worldwide (El-Shafei et al 1992;Serjeant 1992;Howard 1996) and low birth weight is thought to be one of the predisposing factors to this high mortality rate (Serjeant 1992).…”

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

“…The morbidity in sickle pregnant women is also higher with an increase in sickling crisis in both the antenatal and postnatal periods and an increase in pregnancy complications for both the mother and baby. These include an increased risk of urinary tract infections, pulmonary problems, anaemia, proteinuric hypertension, pre-term delivery, low birth weight, and fetal distress in labour and caesarean section (Charache et al 1980;Tuck et al 1983;Dare et al 1992;Poddar et al 1986;Powars et al 1986;el-Shafei et al 1992).…”