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
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.