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How to manage sickle cell disease in Pregnancy

Dr. Lala .A.

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How is sickle cell disease in pregnancy managed?
Early and regular antenatal care is important if you are pregnant and have sickle cell disease. Having antenatal visits more often allows your healthcare provider to keep a close watch on the disease and on the health of developing baby.
Conditions that can predispose to sickle cell crises like exposure to cold, stress, dehydration (possibly from excessive vomiting or not drinking enough water) should be avoided.
Daily use of folic acid is recommended to prevent defects in the unborn child.
Some women may need blood transfusions to replace the sickle cells with fresh blood. These may be done several times during the pregnancy. Blood transfusions can help the blood carry oxygen and lower the number of sickle cells.
Doctors do not recommend using the drug ‘hydroxyurea’ during pregnancy. This drug is often used in HbSS patients to reduce sickling.
Because sickle cell disease may affect your developing baby, your health care provider may start testing in the second trimester to check on the health and well-being of the baby.

During labour, your healthcare provider will give you IV (intravenous) fluids to help prevent dehydration. You may also get extra oxygen through a mask during labor. A fetal heart rate monitor is often used to watch for changes in your baby’s heart rate. It also watches for signs of fetal distress. Most women can deliver vaginally, unless there are other complications.

What are the likely complications from Sickle cell disease in pregnancy?
1.Infections. This includes infection in the urinary tract, kidneys, and lungs.
2. Gallbladder problems, including gallstones
3. Heart enlargement and heart failure from anaemia
4. Miscarriage
5. Death
Complications and increased risks for your developing baby may include:
1. Severe anaemia (very low amount of red blood cells)
2. Reduced growth of the unborn baby.
3. Preterm birth. This means delivery before 37 weeks of pregnancy.
4. Low birth weight. This means less than 2.5kg
5. Stillbirth and newborn death

How do you prevent your children from having Sickle cell anaemia?
If you have sickle cell trait, it is advised that your partner should be tested before you become pregnant, or he should be tested at the first antenatal visit. If the baby’s father has sickle cell trait or other heterozygous form of HbS, you may need amniocentesis, (a test that allows your healthcare practitioner to gather information about your baby’s health from a sample of the fluid that surrounds your baby in the uterus), Or other tests to see if the developing baby has the trait or the disease.

The bottomline is to pay close attention to your health during your pregnancy and report any unusual changes to your doctor.

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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.

2 Comments

2 Comments

  1. wale

    September 20, 2016 at 7:58 pm

    Good day doctor,I wish you to tell me what to do now my fiance is AS and am SC and its just had to let go of 4years relationship.I will like to know if the amniocentesis test during pregnancy is available here in nigerian and if its affordable? Thanks

  2. Dr. O.

    Dr. O.

    September 25, 2016 at 7:45 am

    Hello Wale,
    Pre-natal diagnosis of sickle cell disesase is available in Nigeria, courtesy of the Sickle cell foundation. You can reach them via their contact details below:
    Sickle Cell Foundation Nigeria
    National Sickle Cell Centre,
    Opp Lagos University Teaching Hospital(LUTH),
    Ishaga Road, Idi-araba,
    Lagos. Nigeria.
    P.O Box 3463 Surulere, Lagos
    Telephone
    +234-1-7621522
    +234-803 584 6666
    +234-8100002001
    +234-8100002003
    Email
    [email protected]
    [email protected]

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