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Sickle Cell Vasoocclusive Crisis and Acute Chest Syndrome at Term Pregnancy

Dany Elsayegh, MD, Janet M. Shapiro, MD
Volume: 100 Issue: 1 January, 2007

Abstract:

Women with sickle cell anemia are surviving longer and may desire pregnancy. Rare, life-threatening complications of sickle cell anemia, such as acute chest syndrome, may occur at the time of delivery. A 22-year-old woman with sickle cell (HbS/β+ thalassemia) at 35 weeks of gestation presented with shortness of breath and generalized pain. She was diagnosed with vasoocclusive crisis and acute chest syndrome, managed with exchange transfusion and cesarean delivery, and discharged home with her newborn one week later. Prompt recognition of life-threatening complications of sickle cell anemia in a pregnant woman and collaborative medical and obstetric management are essential to optimize maternal and fetal outcome.


Key Points


* Life-threatening complications of sickle cell disease may occur in the pregnant patient near term.


* Management of acute chest syndrome at term pregnancy may include exchange transfusion before cesarean delivery to optimize maternal and fetal outcome.

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References:

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7. ACGO Committee. ACGO Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists. Obstet Gynecol 2005;106:203–210.
 
8. Sun PM, Wilburn W, Raynor BD, et al. Sickle cell disease in pregnancy: twenty years of experience at Grady Memorial Hospital, Atlanta, Georgia. Am J Obstet Gynecol 2001;184:1127–1130.

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