Pregnancy in sickle cell disease: maternal and fetal outcomes in a population receiving prophylactic partial exchange transfusions |
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Authors: | C. Ngô ,G. Kayem,A. Benachi,F. Galacté ros |
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Affiliation: | a Université Paris XII-Créteil, Obstetrics and Gynecology, CHI Créteil, France b Université Paris XII-Créteil, UMHHR Internal Medicine, Hôpital Henri Mondor APHP, Créteil, France c Université Paris V, Obstetrics, Hôpital Necker-Enfants Malades Paris, France d Université Paris V, Obstetrics, Maternité Port-Royal Paris, France |
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Abstract: | ObjectiveTo describe pregnancy outcomes for pregnant women with sickle cell disease (SCD) receiving prophylactic transfusions.Study designThis retrospective case-control study compared pregnancy outcomes among women with SCD receiving prophylactic transfusions and women without any hemoglobinopathy, matched for ethnicity, parity, age and hospital.ResultsThe study included two groups of pregnancies: 128 in women with SCD (95 with SS phenotype and 33 with SC) and 128 in women with AA phenotype. No woman died. Two perinatal deaths (2.1%) and five alloimmunizations (5.3%) occurred, all in the SS group. Compared with the control group, HbSS disease was more often associated with pre-eclampsia (9.4% versus 2.3%, p = .03), preterm delivery (15.8% versus 6.2%, p = .01), birth weight <10th percentile (13.7% versus 3.9%, p = .008) and caesarean delivery (73.6% versus 26.4%, p < .01).ConclusionDespite prophylactic blood transfusions, SCD remains a severe complicating factor in pregnancy. The policy of systematic transfusions should be analyzed in a sufficiently large randomized trial. |
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Keywords: | Perinatal outcome Pregnancy Prophylactic transfusion Sickle cell disease |
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