Sickle Cell (Disease Anaemia in Pregnancy)

 Sickle Cell (Disease Anaemia in Pregnancy) 

Sickle cell disorders are found most commonly in people of African or west Indian origin.

In this condition defective gene produce abnormal haemoglobin beta chains: the resulting Hb is Hb SS.

 

Sickle Cell Anaemia: Sickle cells have an increased fragility andshortened life span of 17 days resulting in chronic haemolytic anaemia and causing episodes of ischaemia and pain; these are known as sickle cell crisis. Women with sickle cell anaemia may be subfertile but those who do become pregnant may already have organ damages.

 

Precipitating Factors to Crisis;

 

Psychological stress, cold climate, extreme temperature changes, smoking , induced hypoxia, strenuous physical exercise, fatigue, respiratory disease and pregnancy.

 

Signs and Symptoms

 

Jaundice, Anaemia, fatigue, joints pain, epigastric pain, vomiting, abdominal tension, splenomegally, hepatomegally, pyrexia.

 

Effect On Foetus

·              Risk of early abortion

 

·              premature birth

 

·              Intra uterine death

 

Effect on Mother

·              Low immunity.

 

·              Risk of embolism

 

Ante Natal Care

·              Refer to bigger hospital with better equipments for care

 

·              Regular monitoring of haemoglobin level

 

·              Anti-malaria therapy

 

·              Folate supplements

 

·              Blood transfusion every 6 weeks if necessary.

 

·              Advise woman to avoid situation that will precipitate a crisis.

 

·              If crisis occurs, admit patient, rehydrate, treat infection, relief pain, give oxygen therapy and blood transfusion.