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How sickle cell disease may affect your pregnancy

Dr. Lala .A.

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What is Sickle Cell Disease?
Sickle Cell Disease is a blood disorder passed down from parent to children.
People with Sickle cell disease have abnormal haemoglobin. Haemoglobin(Hb) is a protein in red blood cells that carries oxygen to the body. There are different types of haemoglobin; HbA, HbS, HbC, HbF, Hbbeta- thalassemia, HbD, HbE, HbO -Arab. Of all these types of haemoglobin, HbA is the normal type of haemoglobin.

What are the types of Sickle Cell Disease (SCD)?
Sickle cell disease (SCD) is a combination of HbS with HbS (homozygous HbS) or combination of HbS with other types of haemoglobin (heterozygous HbS).
The common types of Sickle Cell disease are;
1. Sickle cell anaemia (HbSS) ; combination of two HbS i.e homozygous HbS.
2. Sickle cell trait (HbAS); combination of HbA and HbS.
3. HbSC; combination of HbS with HbC.
4. HbSB thalassemia); combination of Hb S with Hb beta thalassemia.

What causes the problems in people with sickle cell disease?
The abnormal haemoglobin in sickle cell disease makes the red blood cells stiff and sticky. They form the shape of a sickle, or the letter “C.” These sickle cells tend to clump together and can’t easily move through the blood vessels. The clumps block the flow of healthy, oxygen-carrying blood. This causes pain and damages tissues.

How does sickle cell disease affect pregnancy?
How sickle cell disease affects pregnancy depends on whether you have sickle cell anaemia, sickle cell trait or the other types of heterozygous HbS combinations.
Some women with sickle cell disease have no change in their disease during pregnancy. In others, especially those with HbSS, the disease may get worse.
Painful events called sickle cell crises may still occur in pregnancy. These events may be treated with drugs! that are safe to use during pregnancy.
Generally, women with sickle cell trait (HbAS) do not have problems from the disorder, but they may have a lot of urinary tract infections during pregnancy. Pregnant women with sickle cell trait can also have a kind of anaemia caused by not having enough iron in their blood. If you have this type of anaemia, you may need to take iron supplements.
In pregnancy, it is important for blood cells to be able to carry oxygen. With sickle cell anaemia, the abnormal red blood cells and anaemia may result in lower amounts of oxygen going to your developing baby which can slow down the baby’s growth.

In subsequent articles, we will be discussing how sickle cell in pregnancy can be managed.

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Dr. Lala .A. is a graduate of University of Ilorin who also holds a Diploma in Computer Engineering. She is an MDCN (Medical and Dental Council of Nigeria) certified doctor who aspires to be a plastic surgeon involved in creating awareness about women's rights and responsibilities and also training would be surgeons. She is a proud member of various reputable bodies including the Nigerian Medical Association (NMA) and Young Africa Leaders Initiative (YALI). She loves to read, write, sleep and play the drums in her spare time.