Outcome of Pregnancy in Saudi Women with Sickle Cell Disease Attending the Tertiary Care University Hospital in Eastern Province of Saudi Arabia

Yasmeen Akhtar Haseeb, Nourah Hasan Al Qahtani

Abstract

Sickle cell disease (SCD) is a chronic genetic hematological disorder with multiorgan involvement and is associated with complications during the pregnancy. This is a well-known disorder in Saudi Arabia, but no study has reported its outcomes in pregnant Saudi females of the Eastern region. This study was carried out to compare the fetomaternal outcome in patients with SCD with those without SCD. This was a retrospective cohort study done in the Eastern Province of Saudi Arabia in a tertiary care, teaching hospital, by retrieving the data through the code ICD-9 for SCD, the control group was also selected with comparable characteristics. A total of 302 SCD pregnant patients were included for comparison with 600 pregnant women without SCD as control, during the period of Jan 1, 2008 to December 31, 2018. After the data retrieval, percentages of complications were calculated between the study and control groups. Fischer‘s exact test and t-test were used for statistical analysis by using SPSS version 22. The results showed higher complication rates in pregnancies of patients with SCD. Hypertensive disorders (13.3%), abruptio placenta (1.6%), intrauterine growth restriction (19.2%), thromboembolism (6.6%) and stroke (2.6%) were all higher in SCD as compared to the control group .The complications of SCD itself including anemia (89.4%), acute chest syndrome (13.2%) and sickle cell crisis (39.2%) were also increased during the pregnancy. Both still birth (3.3%) and neonatal intensive care unit admission (1.6%) were also higher in SCD. SCD during the pregnancy is a high-risk situation and can lead to many fetomaternal complications; however, preconceptional counselling, early booking, a careful monitoring during pregnancy and multidisciplinary management approach can prevent potential adverse outcome in this regard.(Afr J Reprod Health 2019; 23[3]: 42-48).

Full Text:

PDF

References

Al-Farsi SH, Al-Riyami NM, Al-Khabori MK, Al-

Hunaini MN. Maternal complications and The Association with Baseline Variables in Pregnant Women with Sickle Cell Disease. Hemoglobin 2013;37(3):219-26

Angastiniotis M, Modell B, Englezos P and Boulyjenkov

V. Prevention and control of haemoglobinopathies. Bull World Health Organ 1995; 73: 375–86.

Diallo D and Tchernia G. Sickle cell disease in Africa.

Curr Opin Hematol 2002;9(2): 111-6.

Quinn CT, Rogers ZR and Buchanan GR. Survival of

children with sickle cell disease. Blood 2004;103(11):4023–8.

Wierenga KJJ, Hambleton IR, Lewis NA and Unit SC.

Survival estimates for patients with homozygous

sickle-cell disease in Jamaica: a clinic-based

population study. Lancet 2001; 357(9257):680–3.

Serjeant GR, Loy LL, Crowther M, Hambleton IR,

Thame M and Paed DM. Outcome of pregnancy in

homozygous sickle cell disease. Obstet Gynecol 2004;103(6):1278–85.

Al Kahtani MA, Alqahtani M, Alshebaily MM, Abd M,

Moawad A and Aljohani N. Morbidity and pregnancy outcomes associated with sickle cell anemia among Saudi women. Int J Gynecol Obstet 2012;119(3):224–6.

Villers MS, Jamison MG, De Castro LM and James AH.

Morbidity associated with sickle cell disease in pregnancy. Am J Obstet Gynecol 2008;199(2):125- e1.

Oteng-ntim E, Meeks D, Seed PT, Webster L, Howard J,

Doyle P and Chappell LC . Adverse maternal and

perinatal outcomes in pregnant women with sickle

cell disease: systematic review and meta-analysis.

Blood 2015; 125(21):3316–26.

Barfield WD, Barradas DT, Manning SE, Kotelchuck M

and Shapiro-Mendoza CK. Sickle cell disease and

pregnancy outcomes: women of African descent.

Am J Prev Med 2010; 38(4):S542-9.

Howard J and Oteng-Ntim E. The obstetric management

of sickle cell disease. Best Practice & Research Clinical Obstetrics & Gynaecology. Best Pract Res Clin Obstet Gynaecol 2012; 26(1):25-36.

Rogers K. Sickle cell disease in pregnancy. Obstet

Gynaecol Reprod Med 2019;29(3):61–9.

Hanley JA, Negassa A and Forrester JE. Statistical

analysis of correlated data using generalized

estimating equations: an orientation. Am J Epidemiol 2003; 157(4):364-75.

Thame M, Lewis J, Trotman H, Hambleton I and

Serjeant G. The mechanisms of low birth weight in

infants of mothers with homozygous sickle cell

disease. Pediatrics 2007; 120(3):e686-93.

Muganyizi PS and Kidanto H. Sickle cell disease in

pregnancy: trend and pregnancy outcomes at a

tertiary hospital in Tanzania. PLoS One 2013;

(2):e56541.

Desai G, Anand A, Shah P, Shah S, Dave K, Bhatt

H,Desai S and Modi D . Sickle cell disease and

pregnancy outcomes: a study of the communitybased

hospital in a tribal block of Gujarat, India. J Heal Popul Nutr 2017;36(1)1–3.

Barfield WD, Barradas DT, Manning SE, Kotelchuck M

and Shapiro-mendoza CK. Sickle cell disease and

pregnancy outcomes. AMEPRE 2010; 38(4):S542–

Knight M, McClymont C and Fitzpatrick K. on behalf of

UKOSS. United Kingdom Obstetric Surveillance System (UKOSS) Annual Report 2012. National Perinatal Epidemiology Unit. Oxford; 2012.

Gilli SC, Paula EV De, Biscaro FP, Marques JF, Costa

FF and Saad ST. Third-trimester erythrocytapheresis in pregnant patients with sickle cell disease. Int J Gynaecol Obstet 2007;96(1):8–11.

Asma S, Kozanoglu I, Gereklioglu C, Akdeniz A, Kasar

M, Turgut NH,Yeral M,Kandemir F,Boga C and Ozdogu H . Prophylactic red blood cell exchange may be beneficial in the management of sickle cell disease in pregnancy. Transfusion 2015; 55(1):36– 44.

Sharif J, Byrd L, Stevenson K, Raddats J, Morsman E

and Ryan K. Transfusion for sickle cell disease in pregnancy: a single‐centre survey. Transfusion 2018; 28(3):231-5.

Ngo C, Kayem G, Habibi A, Benachi A, Goffinet F,

Galacteros F and Haddad B. Pregnancy in sickle cell disease: maternal and fetal outcomes in a population receiving prophylactic partial exchange transfusions. Eur J Obstet Gynecol Reprod Biol 2010; 152(2):138-42.

RCOG Green top guideline no 61. Management of Sickle

Cell Disease in Pregnancy. July,2011;(61).

Hassell Kathryn. Pregnancy and Sickle Cell Disese.

Hematology/Oncology Clinics 2005; 19(5):903-16.

Refbacks

  • There are currently no refbacks.