- March 7, 2016
- Posted by: emobile
- Category: Patient's Corner
Emobileclinic Patient’s corner
Pregnancy aggravates the medical complications of the sickle cell disease and the disease complicates pregnancy, leading to high levels of maternal and perinatal mortality. Maternal mortality ratio of 47.6 – 121/ 1000 deliveries and a perinatal mortality rate of 67-250/1000 births have been reported.
Common complications noted in pregnancy are anaemia, bone pain crisis and malaria. Pneumonia, pyelonephritis, pre-eclampsia, preterm labour and other systemic infections are also know to complicate pregnancy in sickle cell disease patients.
Most common foetal complications are intrauterine growth restriction and intrauterine foetal death. Acute chest syndrome can occur at any time throughout pregnancy and during the post-partum period. A rather grave complication is pseudo-toxaemia which is a complication of bone marrow crisis characterized by systolic hypertension, proteinuria and severe bone pain.
It is associated with bone marrow fat embolism and is highly fatal with worse prognosis. Though it has been reported that anaemia and painful crisis are more frequent in the last 4 weeks of pregnancy and can precipitate labour, many others however are spared this complication especially those attending pre-conceptional as well as antenatal clinic.
Sickle cell disease in pregnancy also increases the rate of caesarean section as well as instrumental deliveries with the aim of improving perinatal outcome and reducing maternal morbidity and mortality.