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... disorders complicated 3 of the pregnancies. There were 3 deaths among the women with SCA during the study period giving a mortality rate of 9.7 per 100,000 Table 3 shows there were a total of 14 live births (82.4%) and 3 stillbirths in the study population with a stillbirth rate of 0.1 per 1000 live births (Mode of delivery was spontaneous vaginal in 2 and repeat caesarean section in 1). Two of these stillbirths were preterm. ...
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... 9,15 Similar to many other studies, we found that obstetric complications like preeclampsia and gestational hypertension were high in women with sickle cell disease with a higher risk in homozygous (HbSS) genotype. [9][10][11][15][16][17][18][19] Eclampsia which is a life threatening complication of preeclampsia was reported to be 10 times high in HbSS women. 17 This study also showed a higher incidence of eclampsia in consistent with an earlier metaanalysis and also reports from other states of India. ...
... 10 Infective complications observed in this study were mainly urinary tract infections and pneumonia which were controlled without further complications. 17,19,22 Infections was the cause of maternal mortality in 82% of SCD women in Tanzania. 24 Unlike many studies which showed a higher rate of malarial infections in pregnant women with SCD, we did not have a single patient with malaria. ...
... More than 60% of sickle cell deliveries required blood transfusion with about a third of the total patients requiring three or more transfusions which was very high comparing with 52.7% transfusions as reported recently by Desai G et al with only 8.4% requiring 3 or more transfusions.20 Sickle cell crisis, one of the acute complication of SCD has been shown to increase antepartum hospital admissions.19,21 Pregnancy has been shown to exacerbate sickle cell crises with as high as 100% incidence of vasoocclusive crisis in pregnant women with SCD.12,19,22,23 Pinto S et al has reported vasoocclusive crisis in 61.7% of pregnant SCD patients and acute chest syndrome as high as 29.4%. ...
Background: Pregnancy is a serious burden to women with sickle cell disease (SCD). Our centre is the only tertiary care referral centre in the public sector which caters to the districts of Wayanad and the Nilgiris which has the maximum prevalence for SCD in South India. Hence this study was conducted to assess complications in pregnancy and maternal and perinatal outcome among women with SCD.Methods: A retrospective observational study was conducted by reviewing the medical records of all the pregnant women with SCD who had delivered in the Department of Obstetrics and Gynecology, Government Medical College, Kozhikode from January 2014 to December 2016.Results: There were 72 antenatal women with SCD during the study period with a prevalence of 0.15%. 54.17% (n = 39) patients were HbSS (sickle cell anemia), 44.44% (n = 32) were HbAS (sickle cell trait) and 1.39% (n = 1) were HbS-β thalassemia trait. There was increased risk of obstetric complications like gestational hypertension (16%), preeclampsia (11.11%), eclampsia (5.56%), HELLP syndrome (4.16%), intrauterine growth retardation (38.89%), and oligohydramnios (18.06%). Medical complications observed were mainly anaemia (76.38%), vasoocclusive crisis (18.05%), acute chest syndrome (5.56%) and infections like urinary tract infection (8.33%) and pneumonia (5.56%). The incidence of low birth weight babies (56.94%), low Apgar score (14.49%) and neonatal ICU admissions (31.88%) were high. There was no maternal mortality, but perinatal mortality was high (6.94%).Conclusion: Pregnancy in SCD is associated with an increased maternal morbidity and high perinatal mortality due to obstetric and medical complications.
