Fetomaternal outcome in sickle cell disease in a tertiary care centre

Authors

  • Rahi S. Modi Department of Obstetrics and Gynecology, Medical College Baroda, Vadodara, Gujarat, India http://orcid.org/0000-0001-8118-0805
  • Srushti S. Patel Department of Obstetrics and Gynecology, Medical College Baroda, Vadodara, Gujarat, India
  • Dipti A. Modi Department of Obstetrics and Gynecology, Medical College Baroda, Vadodara, Gujarat, India
  • Heena Talesara Department of Obstetrics and Gynecology, Medical College Baroda, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20210315

Keywords:

Maternal morbidity, Maternal mortality, Perinatal outcome, Perinatal mortality, Sickle cell disease, Vaso-occlusive crisis

Abstract

Background: Sickle cell disease is a hereditary haematological disorder prevalent in tribal regions of India. Sickle cell disease can increase complications during pregnancy and in turn negatively influence pregnancy outcomes. This study reports the analysis of tribal maternal admissions in the tertiary centre S.S.G. Hospital, Baroda, Gujarat. Hence this study was conducted to assess complications in pregnancy and maternal and perinatal outcome among women with Sickle cell disease.

Methods: It was a retrospective observational study including all pregnant women with sickle cell disease after 20 weeks of gestation who delivered at S.S.G. Hospital, Baroda from August 2019 to August 2020.

Results: There were 43 antenatal women with Sickle cell disease during the study period. There was increased risk of obstetric complications like gestational hypertension (11.62%), preeclampsia (9.3%), eclampsia (6.97%), HELLP syndrome (4.65%), intrauterine growth retardation (23.25%), and oligohydramnios (11.62%). Medical complications observed were mainly anaemia (53.48%), vaso-occlusive crisis (18.16%), acute chest syndrome (4.65%) and infections like urinary tract infection (6.97%) and pneumonia (4.65%). The incidence of low birth weight babies (56.94%), low APGAR score (11.62%) and neonatal ICU admissions (23.25%) was high. 6.5% cases of maternal mortality and 4.65% cases of perinatal mortality was observed.

Conclusions: Pregnancy in Sickle cell disease is associated with an increased maternal morbidity and high perinatal mortality due to obstetric and medical complications.

Author Biographies

Rahi S. Modi, Department of Obstetrics and Gynecology, Medical College Baroda, Vadodara, Gujarat, India

THIRD YEAR RESIDENT, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, MEDICAL COLLEGE BARODA.

Srushti S. Patel, Department of Obstetrics and Gynecology, Medical College Baroda, Vadodara, Gujarat, India

SECOND YEAR RESIDENT, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, MEDICAL COLLEGE BARODA.

Dipti A. Modi, Department of Obstetrics and Gynecology, Medical College Baroda, Vadodara, Gujarat, India

ASSOCIATE PROFESSOR, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, MEDICAL COLLEGE BARODA.

Heena Talesara, Department of Obstetrics and Gynecology, Medical College Baroda, Vadodara, Gujarat, India

THIRD YEAR RESIDENT, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, MEDICAL COLLEGE BARODA.

References

Rees DC, Williams TN, Gladwin MT. Sickle-cell disease. Lancet. 2010;376:2018-49.

Piel FB, Hay SI, Gupta S, Weatherall DJ, Williams TN. Global burden of sickle cell anaemia in children under five, 2010-2050: modelling based on demographics, excess mortality, and interventions. PLoS Medicine. 2013;10(7):22-9.

Colah RB, Mukherjee MB, Martin S, Ghosh K. Sickle cell disease in tribal populations in India. Indian J Med Res. 2015;141:121-7.

Bhukhanvala D, Gupte S, Patel A, Shah A, Sorathiya S. Prevalence and hematological profile of β-thalassemia and sickle cell anemia in four communities of Surat city. Indian J Human Genetics. 2012;18(2):167-71.

Sparkenbaugh E, Pawlinski R. Interplay between coagulation and vascular inflammation in sickle cell disease. British J Haematol. 2013;162:3-14.

Ugboma H, George I. Sickle cell disease in pregnancy: maternal and fetal outcome in Port Harcourt, Nigeria. British J Medicine Medical Res. 2015;7(1):40-4.

Elenga N, Adeline A, Balcaen J, Vaz T, Calvez M, Terraz A, et al. Pregnancy in sickle cell disease is a very high-risk situation: an observational study. Obstet Gynecol Int. 2016;2016.

Oteng NE, Meeks D, Seed PT, Webster L, Howard J, Doyle P, et al. Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis. Blood. 2015;125(21):3316-25.

Silva-Pinto AC, Ladeira SOD, Brunetta DM, Santis GC, Angulo IL, Covas DT. Sickle cell disease and pregnancy: analysis of 34 patients followed at the regional blood center of ribeirão preto, Brazil. Revista Brasileira de Hematologia e Hemoterapia. 2014;36(5):329-33.

Wilson NO, Ceesay FK, Hibbert JM, Driss A, Obed SA, Adjei AA, et al. Pregnancy outcomes among patients with sickle cell disease at Korle-Bu Teaching Hospital, Accra, Ghana: retrospective cohort study. Am J Tropical Med Hygiene. 2012;86(6):936-42.

Ngô C, Kayem G, Habibi A, Benachi A, Goffinet F, Galactéros F, et al. Pregnancy in sickle cell disease: Maternal and fetal outcomes in a population receiving prophylactic partial exchange transfusions. European J Obst Gynecol Reproductive Biol. 2010;152(2):138-42.

Jama FE, Gasem T, Burshaid S, Rahman J, Suleiman SA, Rahman MS. Pregnancy outcome in patients with homozygous sickle cell disease in a university hospital, Eastern Saudi Arabia. Arch Gynecol Obst. 2009;280(5):793-7.

Desai G, Anand A, Shah P, Shah S, Dave K, Bhatt H, et al. Sickle cell disease and pregnancy outcomes: a study of the community-based hospital in a tribal block of Gujarat, India. J Health Population Nutrition. 2017;36(1):3.

Yu CKH, Stasiowska E, Stephens A, Awogbade M, Davies A. Outcome of pregnancy in sickle cell disease patients attending a combined obstetric and haematology clinic. J Obst Gynaecol. 2009;29(6):512-6.

Orazulike FN, Ijeoma FC. Feto-maternal outcome in patients with sickle cell anaemia at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria: a ten year retrospective review. Int J Obstet Gynecol. 2015;3:54-8.

Muganyizi PS, Kidanto H. Sickle cell disease in pregnancy: trend and pregnancy outcomes at a tertiary hospital in Tanzania. PLoS ONE. 2013;8(2):34-8.

Acharya N, Kriplani A, Hariharan C. Study of perinatal outcome in pregnancy with sickle cell disease. Int J Biol Med Res. 2013;4(2):3185-8.

Downloads

Published

2021-01-28

Issue

Section

Original Research Articles