Pregnancy outcomes in women with sickle cell disease: a retrospective study from Eastern India

Patel, Siris; Purohit, Prasanta; Jit, Bimal Prasad; Meher, Satyabrata

doi:10.1080/01443615.2019.1571024

Cited by 7 publications

(6 citation statements)

References 9 publications

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“…Pregnancies in women with sickle cell disease (SCD) are associated with increased rates of maternal and fetal mortality and adverse outcomes (Eissa et al, 2015;Kuo and Caughey, 2016;Ware et al, 2017;Jain et al, 2019;Patel et al, 2019). The physiological changes of pregnancy (increased metabolic demand, rise of blood viscosity, hypercoagulability) are aggravated in SCD women leading to increased incidence of complications.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy in Thalassemia and Sickle Cell Disease: The Experience of an Italian Thalassemia Center

Sorrentino

Maffei

Caprari

et al. 2020

Front. Mol. Biosci.

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The life expectancy of thalassemia patients has increased significantly in recent years being the most "elderly" patients approaching or are over 50 years old. Consequently, patients' perspectives have changed, leading them to longer-term planning with a consequent increase in their reproductive potential and desire to have children. Crucial points in the management of pregnancy in thalassemia are the iron chelation therapy before and during pregnancy, the antithrombotic prophylaxis, the management of transfusion therapy according to the modified transfusion requirement, a cardiologic monitoring for hemodynamic changes that expose an increased risk of heart failure. Pregnancy in women with sickle cell disease is still associated with increased rates of maternal and fetal mortality and adverse outcomes. Maternal morbidity may be due to acute sickling crises, thromboembolism, infection, and chronic end-organ dysfunction, while neonatal outcomes may be intrauterine growth retardation, preterm delivery, small infants for gestational age, stillbirth, and neonatal death. The management of pregnancy in thalassemia and sickle cell disease requires to be approached by a multidisciplinary team and followed from the pre-conception phase until the post-partum period with a close monitoring of the maternal and fetal conditions, in order to ensure optimal outcome. This approach requires the application of well-defined protocols that cover all the critical aspects of pregnancies in women affected by these pathologies. We describe our experience of spontaneous and non-spontaneous pregnancies in patients with thalassemia major and intermedia and sickle cell disease followed between 1992 and 2018 at the Thalassemia Unit of S. Eugenio Hospital of Rome.

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Section: Introductionmentioning

confidence: 99%

Pregnancy in Thalassemia and Sickle Cell Disease: The Experience of an Italian Thalassemia Center

Sorrentino

Maffei

Caprari

et al. 2020

Front. Mol. Biosci.

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“…Interestingly the majority of these women were SS homozygotes but we had one patient with SC an At the time of enrollment, more than two-thirds of the women were pubescent (n = 704, 68.3%) and therefore they were considered to be of childbearing age. The median age of the first mensestruation was 15 [13][14][15][16][17][18][19] years. Forty-eight girls reached puberty during the study, but none of them became pregnant.…”

Section: Resultsmentioning

confidence: 99%

“…Mechanistically, HU was shown to be able to induce the production of hemoglobin F through the recruitment of a population of erythroid precursors that can continue γ-chain synthesis [16]. Only a few cases of HU exposure during pregnancy in women with SCD have been published [17][18][19][20]. Importantly, as no malformation in newborns was reported due to HU treatment to date, it was suggested that the risk of deleterious teratogenic effects shown in some animal species, such as mice and monkeys, at the doses comparable to human doses (in mg/m 2 ) may have been overestimated in humans [21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Pregnancy in Sickle Cell Disease Patients: Results from the Prospective ESCORT-HU Cohort Study

et al. 2023

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Sickle cell disease (SCD) refers to a group of inherited hemoglobin disorders in which sickle red blood cells display altered deformability, leading to a significant burden of acute and chronic complications, such as vaso-occlusive pain crises (VOCs). Hydroxyurea is a major therapeutic agent in adult and pediatric sickle cell patients. This treatment is an alternative to transfusion in some complications. Indeed, it increases hemoglobin F and has an action on the endothelial adhesion of red blood cells, leukocytes, and platelets. Although the safety profile of hydroxyurea (HU) in patients with sickle cell disease has been well established, the existing literature on HU exposure during pregnancy is limited and incomplete. Pregnancy in women with SCD has been identified as a high risk for the mother and fetus due to the increased incidence of maternal and non-fetal complications in various studies and reports. For women on hydroxyurea at the time of pregnancy, transfusion therapy should probably be initiated after pregnancy. In addition, there is still a significant lack of knowledge about the incidence of pregnancy, fetal and maternal outcomes, and management of pregnant women with SCD, making it difficult to advise women or clinicians on outcomes and best practices. Therefore, the objective of this study was to describe pregnancy outcomes (n = 128) reported in the noninterventional European Sickle Cell Disease COhoRT-HydroxyUrea (ES-CORT-HU) study. We believe that our results are important and relevant enough to be shared with the scientific community.

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“…In a recent retrospective study carried out in women with sickle cell disease from the state of Odisha, 25% of the pregnancies were unsuccessful. 26 This needs attention for the early diagnosis and management of pregnant women with sickle cell disorders in the state.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of hemoglobin disorders in southern Odisha, India: a hospital based study

Sahu¹,

Purohit

Mantri

et al. 2021

Porto Biomedical Journal

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Background: Hemoglobin disorders are the leading health concern in the world including India. There is a paucity of literature on the spectrum of hemoglobin disorders in southern districts of Odisha state. This study was undertaken to elucidate the occurrence of different hemoglobin disorders in a tertiary health care facility of Odisha state, India. Methods: The study cases were suspected patients of all age groups advised for screening of different hemoglobin disorders. Hemoglobin disorders were screened by sickling slide test and high-performance liquid chromatography (HPLC) using the Variant-II hemoglobin testing system as per the manufacturer's guidelines. Results: Over 2 years, 2332 blood samples (including 1102 pediatric and 1230 adult cases) were investigated, out of which, 1380 (59.2%) of cases had abnormal hemoglobin disorders. The most common was sickle cell disorders (48.67%, 1135/2332) followed by β-thalassemia (11.32%, 264/2332). Some rare variants were detected as hemoglobin D -Punjab , hemoglobin E, hemoglobin Lepore, hereditary persistence of fetal hemoglobin, hemoglobin with high P2 window, hemoglobin with high P3 window etc, Among the cases with abnormal hemoglobin disorders, 744 (53.9%), 545 (39.5%) and, 91 (6.6%) cases were found to have the heterozygous, homozygous and, double heterozygous state. Of the 188 ante-natal cases screened, 31.4% of cases had abnormal hemoglobin variants with sickle cell disorders being the most prevalent one. Conclusion: Along with the high occurrence of sickle cell disorders in the study area, some other rare hemoglobin disorders are also prevalent which calls for a large community-based cohort study.

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Pregnancy outcomes in women with sickle cell disease: a retrospective study from Eastern India

Cited by 7 publications

References 9 publications

Pregnancy in Thalassemia and Sickle Cell Disease: The Experience of an Italian Thalassemia Center

Pregnancy in Thalassemia and Sickle Cell Disease: The Experience of an Italian Thalassemia Center

Outcomes of Pregnancy in Sickle Cell Disease Patients: Results from the Prospective ESCORT-HU Cohort Study

Spectrum of hemoglobin disorders in southern Odisha, India: a hospital based study

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