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Sickle Cell Disease in Pregnancy

Angelique S Forrester, MD Reviewed 05/2023
 


BASICS

Sickle cell disease (SCD), is an inherited homozygous genetic mutation and is one of the most common hematological disorders. It affects the formation and function of red blood cells in the bod...

DIAGNOSIS

HISTORY

  • It is critical to identify signs and symptoms related to hemolysis, vaso-occlusive disease, or infection early to avoid rapid decompensation.

  • Threshold for hospitalization with close m...

TREATMENT

  • Preconception counseling (1,3,6):

    • Women with SCD should seek preconception care to confirm diagnosis and receive counseling on possible pregnancy complications secondary to SCD (1)[C].

    • Offer...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Progesterone-only and barrier methods recommended for contraception.

  • Do not restart hydroxyurea until patient has finished breastfeeding.

Patient Monitoring

  • Regular ...

REFERENCES

1
Smith-Whitley, K. Complications in pregnant women with sickle cell disease. Hematology AM Soc Hematol Educ Program. 2019;2019(1):359–366.
2
Wilson S, Ellsworth P, and Key NS. Pregnancy in si...

ADDITIONAL READING

  • Alayed  N, Kezouh  A, Oddy  L, et al. Sickle cell disease and pregnancy outcomes: population-based study on 8.8 million births. J Perinat Med.  2014;...

CODES

ICD10

  • O99.019 Anemia complicating pregnancy, unspecified trimester

  • D57.1 Sickle-cell disease without crisis

  • D57.3 Sickle-cell trait

SNOMED

  • 27342004 Anemia of pregnancy (disorder)

  • 127040003 Hereditary ...

CLINICAL PEARLS

  • Preconception counseling for women with SCD is important.

  • Once pregnant, patient will require close guideline-based antepartum monitoring.

  • SCD is associated with increased maternal and f...

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