Pregnancy in sickle cell disease in the UK

Tuck, Susan M.; Studd, John; White, Joseph

doi:10.1111/j.1471-0528.1983.tb08893.x

Cited by 57 publications

(12 citation statements)

References 22 publications

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“…Our observation that UTI is increased in women with SCD (11% overall, 19Á6% in HbSS) is reflected in findings from previous studies (Tuck et al, 1983;Al-Suleiman et al, 1991;Al Jama et al, 2009;Yu et al, 2009). It has been suggested that this may be explained by the finding of abnormally dilute and alkaline urine in patients with SCD, which increases the likelihood of bacterial proliferation (Akinbami et al, 2014).…”

Section: Discussionsupporting

confidence: 81%

“…Worldwide historical data shows a high incidence of maternal and fetal complications (Al-Suleiman et al, 1991;Smith et al, 1996;Barfield et al, 2010;Sun et al, 2001;Serjeant et al, 2004Serjeant et al, , 2005Rajab et al, 2006;Chakravarty et al, 2008;Villers et al, 2008;Afolabi et al, 2009;Al Jama et al, 2009;Asnani et al, 2011;Wilson et al, 2012;Al-Farsi et al, 2013), but most studies are single-centred and retrospective in nature and involve small numbers of respondents. There are four publications from the UK, two of which are surveys based on data over 18 years old and, in view of changes in management over this time, are unlikely to reflect current practice and outcomes (Tuck et al, 1983;Howard et al, 1995). The most recent studies from the UK are from single or small numbers of specialist centres, and so may not reflect practice and outcome across the whole of the UK (Yu et al, 2009;Chase et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy outcome in patients with sickle cell disease in the UK – a national cohort study comparing sickle cell anaemia (HbSS) with HbSC disease

et al. 2014

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SummaryWe describe the findings from a national study of maternal and fetal outcomes of pregnancy in women with sickle cell disease (SCD). Data were collected via the United Kingdom Obstetric Surveillance System between 1 February 2010 and 31 January 2011 from 109 women, of whom 51 (46Á8%) had HbSS and 44 (40Á4%) had HbSC. Data included antenatal, maternal and fetal outcomes. Comparisons were made between women with HbSS and HbSC. Incidence of complications were acute pain (57%), blood transfusion (26%), urinary tract infection (UTI; 12%) and critical care unit admission (23%) and these were all more common in women with HbSS than HbSC. There was no difference in the incidence of acute chest syndrome, hypertension and venous thromboembolism between HbSS and HbSC. Women with HbSS were more likely to deliver at <37 weeks gestation (P = 0Á01) and their babies were more likely to have reduced birth weight. Delivery at <34 weeks was increased in both HbSS and HbSC women (5Á9% vs. 4Á6%) compared to national data. This study confirms a high rate of maternal and fetal complications in mothers with SCD, even in women with HbSC, which has previously been considered to have a more benign phenotype in pregnancy.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Pregnancy outcome in patients with sickle cell disease in the UK – a national cohort study comparing sickle cell anaemia (HbSS) with HbSC disease

et al. 2014

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“…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).…”

Section: Introductionmentioning

confidence: 99%

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

Yu¹,

Stasiowska²,

Stephens

et al. 2009

Journal of Obstetrics and Gynaecology

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This study aims to determine the pregnancy outcomes in women attending the combined obstetric sickle cell clinic at King's College Hospital, London from June 2000 to July 2006. There were 71 pregnancies in 65 women with sickle cell disease. Sickle crisis requiring admission occurred in 47% of the antenatal patients. The first admission occurred most frequently in the third trimester (23 vs 6 and 5 admissions in the second and first trimester; p < 0.001). There were no maternal deaths; other complications include anaemia requiring blood transfusion (32%), proteinuric hypertension (9%), infections (28%) and emergency caesarean section (30%). There was one fetal demise due to abruption. Pre-term delivery before 34 weeks occurred in 8% and 24% before 37 weeks. A total of 18% of infants had reduced growth velocity with the measurements crossing below the 10th centile.

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“…SCD is not associated with decreased fertility in women, but those women who become pregnant are at a higher risk for maternal and fetal complications than the general population. More than one-third of pregnancies in women with SCD end in abortion, stillbirth, or neonatal death [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Sickle Cell Disease and Pregnancy: Does Outcome Depend on Genotype or Phenotype?

Berzolla¹,

Seligman²,

Nnoli³

et al. 2011

IJCM

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Objective: Women with Sickle Cell Disease (SCD) who become pregnant are at risk for serious maternal and fetal complications. Our objective was to determine if pregnancy outcome is dependent on phenotype. Methods: Retrospective cohort study of pregnant women with SCD, including hemoglobin (Hb) SS, Hb SC, and Hb Sβ-thalassemia, between January 1999 and December 2008). Antenatal and neonatal outcomes were compared between pregnancies with painful episodes and those without. The primary outcome was preterm birth (PTB) <37 weeks. Secondary outcomes included maternal medical complications, antenatal complications, delivery outcomes, and neonatal outcomes. Results: 31 women were included (18 (58%) with painful episodes, 13 (42%) without painful episodes). The median number of painful episodes was 2.5 (1 - 19) and these women required a median of 13 total days (1 - 59) of inpatient treatment. At delivery, women who had experienced painful episodes had lower Hb levels and were more likely to be taking chronic narcotic pain medications. The overall incidence of PTB <37wks was 55% and was not significantly different between groups (11 [61%] with painful episodes versus 6 [46%] without painful episodes; p = 0.485). Secondary outcomes were also not significantly different between groups. There was one maternal death. Conclusion: Adverse obstetrical out-comes were more common among women with sickle cell disease who experienced painful crises however, in this small sample, the difference were not statistically significant

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Pregnancy in sickle cell disease in the UK

Cited by 57 publications

References 22 publications

Pregnancy outcome in patients with sickle cell disease in the UK – a national cohort study comparing sickle cell anaemia (HbSS) with HbSC disease

Pregnancy outcome in patients with sickle cell disease in the UK – a national cohort study comparing sickle cell anaemia (HbSS) with HbSC disease

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

Sickle Cell Disease and Pregnancy: Does Outcome Depend on Genotype or Phenotype?

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