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ORIGINAL ARTICLE
Year : 2017  |  Volume : 6  |  Issue : 4  |  Page : 242-246

Sickle cell disease complicating pregnancy: A retrospective study


Department of Obstetrics and Gynaecology, Mamata Medical College, Khammam, Telangana, India

Correspondence Address:
Dr. B Kavitha
Department of Obstetrics and Gynaecology, Mamata Medical College, Khammam - 507 002, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JDRNTRUHS.JDRNTRUHS_3_17

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Introduction: Sickle cell disease is an uncommon cause of anemia and jaundice during pregnancy. Sickle cell crisis may lead to several maternal and fetal complications. Aims: To study maternal and fetal complications in pregnant patients with sickle cell disease. Settings and Design: Retrospective study was carried out from case records at Mamata Medical College over a period of five years from July 2011 to June 2016. Patients and Methods: Among 17 pregnancies in 12 cases, we studied the baseline characteristics of study population, frequency of sickle hemoglobin variants, and complications to mother and baby. Statistical Analysis Used: Compiled data was analyzed by simple descriptive statistics and frequency tables. Results: Most cases were primigravida (58.3%). Most common presenting features were anemia and jaundice (hemolytic crisis, 70.58%) and bone and joint pains (painful crises, 41.17%). Acute chest syndrome was seen in 5.88% of the patients. Pregnancies were complicated by severe anemia (Hb <7 gm%) in 29.41% of patients, by jaundice - 76.47%, urinary tract infection - 47.05%, pre-eclampsia - 11.76%, and hepatosplenomegaly - 17.64%. Fetal/neonatal complications were intra-uterine growth restriction (IUGR, 35.29%), perinatal death (17.64%), preterm delivery (35.3%), fetal distress (41.17%), meconium stained liquor (29.41%), meconium aspiration syndrome (11.76%), and low birth weight (58.82%). Sickling test was positive in all cases. Hemoglobin electrophoresis showed HbS. HbSS was the commonest form of sickle cell disease. Discussion: Because of hematological changes, extra demands, and sickle crisis, complications to both mother and fetus are more common in sickle cell anemia during pregnancy than in non-pregnant state. Conclusions: Although sickle cell anemia during pregnancy is usually associated with complications, prompt recognition and careful management reduces morbidity and mortality associated with them.


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