How does sickle cell disease affect pregnancy?

Sickle cell disease and pregnancy

Are you a sickle cell patient planning to get pregnant, or you’re already pregnant and need more info about pregnancy and sickle cell disease (SCD)? The impact SCD has on pregnancy depends on whether your condition is sickle cell disease or sickle cell trait. In some cases, your pregnancy does not change the SCD in your body. In others, the disease may worsen, provoking sickle cell crises. This would require treatment only with medicines that are labeled as safe to use during pregnancy. Note that women with SCD, kidney disease or heart failure are likely to worsen during pregnancy.

Your blood cells should be able to transport oxygen. But with sickle cell anemia, red blood cells are abnormal and that leads to lower amounts of oxygen reaching your developing baby. This delays the growth of the baby.

How is sickle cell disease in pregnancy treated?

If you have sickle cell trait and are pregnant, you may not experience any complications. However, your baby will have SCD if the father also has the trait. Experts recommend that your partner gets tested before you become pregnant or at your first prenatal visit.

Why should you pay frequent prenatal visits? Early and regular prenatal visits are so essential for pregnant women with sickle cell disease. They make it easier for your healthcare provider to monitor the disease and how it may affect the baby’s development.

The need for blood transfusion

In some instances, a woman may require a blood transfusion in order to get fresh blood to replace the sickle cells. This method of treatment may be carried out a couple of weeks into the pregnancy. With blood transfusions, your body can transport oxygen more effectively than before and reduce the number of sickle cells. Experts recommend that after getting blood transfusions, you have to be screened for antibodies that may have been transported in the blood and may harm your baby.

Doctors don't advise that you take hydroxyurea during pregnancy though it’s usually used for treating sickle cell disease. Nevertheless, taking lower doses of hydroxyurea may be okay.

SCD may affect your baby’s growth. So, it’s important that your healthcare provider starts testing in the second trimester to ensure that the health and well-being of your baby is monitored for timely treatment.

Another treatment method during labour is to receive IV (intravenous) fluids from your healthcare provider to help prevent fluid loss (dehydration). Also, during labour, you may need to use an oxygen mask for extra oxygen! A fetal heart rate monitor is required sometimes for watching changes in the baby’s heart rate. It watches for signs of fetal distress as well. Most women with SCD can give birth vaginally, except when other complications are preventing it.

What are the possible complications and increased risks from sickle cell disease during pregnancy?

· Infections such as in the urinary tract, lungs and kidneys

· Anemia-related heart enlargement and heart failure

· Gallbladder problems, like gallstones

· Miscarriage

· Death

Complications and increased risks for your developing baby may include:

· Severe anemia

· Slow fetal growth

· Light-weighted at birth (below 5.5 pounds)

· Preterm birth (in less than 37 weeks of pregnancy)

· Stillbirth and newborn death