Review Article

CME Article: Sickle Cell Disease in Pregnancy

Authors: Amanda Redden Hathaway, MD

Abstract

Sickle cell disease (SCD) is the most common hereditary disorder and affects 30 million people worldwide. Advances in science have improved overall survival in patients with SCD and as such, more patients are reaching reproductive age and are becoming pregnant. SCD in pregnancy leads to multiple complications that put both the mother and fetus at risk, and patients with SCD have six times the mortality during pregnancy as compared with patients without SCD. This review summarizes the maternal and fetal risks of patients with SCD and makes recommendations on how best to care for these patients throughout all stages of pregnancy.

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References

1. Boga C, Ozdogu H. Pregnancy and sickle cell disease: a review of the current literature. Crit Rev Oncol Hematol 2016;98:364-374.
 
2. Boulet SL, Okoroh EM, Azonobi I, et al. Sickle cell disease in pregnancy: maternal complications in a Medicaid-enrolled population. Matern Child Health J 2013;17:200-207.
 
3. de Montalembert M, Deneux-Tharaux C. Pregnancy in sickle cell disease is at very high risk. Blood 2015;125:3216-3217.
 
4. Perseghin P. Erythrocyte exchange and leukapheresis in pregnancy. Transfus Apher Sci 2015;53:279-282.
 
5. Villers MS, Jamison MG, De Castro LM, et al. Morbidity associated with sickle cell disease in pregnancy. Am J Obstet Gynecol 2008;199:125.e121-125.e125.
 
6. Oteng-Ntim E, Meeks D, Seed PT, et al. Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis. Blood 2015;125:3316-3325.
 
7. Barfield WD, Barradas DT, Manning SE, et al. Sickle cell disease and pregnancy outcomes: women of African descent. Am J Prev Med 2010;38(4 Suppl):S542-S549.
 
8. Parrish MR, Morrison JC. Sickle cell crisis and pregnancy. Semin Perinatol 2013;37:274-279.
 
9. Boafor TK, Olayemi E, Galadanci N, et al. Pregnancy outcomes in women with sickle-cell disease in low and high income countries: a systematic review and meta-analysis. BJOG 2016;123:691-698.
 
10. Serjeant GR, Loy LL, Crowther M, et al. Outcome of pregnancy in homozygous sickle cell disease. Obstet Gynecol 2004;103:1278-1285.
 
11. Malinowski AK, Shehata N, D’ R, et al. Prophylactic transfusion for pregnant women with sickle cell disease: a systematic review and meta-analysis. Blood 2015;126:2424-2435.
 
12. Koshy M, Burd L, Wallace D, et al. Prophylactic red-cell transfusions in pregnant patients with sickle cell disease. A randomized cooperative study. N Engl J Med 1988;319:1447-1452.
 
13. Morrison JC, Morrison FS, Floyd RC, et al. Use of continuous flow erythrocytapheresis in pregnant patients with sickle cell disease. J Clin Apher 1991;6:224-229.