Recognizing and managing the enormous challenges that women with sickle cell disease face is essential for protecting the health of both mother and child, particularly during pregnancy. Sickle cell disease, a genetic blood ailment, can lead to anemia, painful episodes, and an elevated risk of infection, all of which can be exacerbated by the physical demands of pregnancy. Women with sickle cell disease are at increased risk for complications such as preeclampsia, preterm labor, and placental abruption, posing risks to both the developing fetus and the mother.
The illness can exacerbate the physical changes and demands of pregnancy, causing persistent discomfort and exhaustion. Routine prenatal care with a medical professional skilled in high-risk pregnancies is crucial for tracking and managing these risks. This care includes regular examinations, blood transfusions as needed, and medications for pain and infection prevention.
Regular prenatal care, including blood transfusions and pain medications, is crucial.(Image Credit:Canva)
Maintaining a healthy diet, staying hydrated, and minimizing stress are essential for symptom management and overall health. By being aware of these challenges and taking proactive measures, pregnant women with sickle cell disease can navigate pregnancy more safely, benefiting both the mother and the unborn child. In a conversation with Jagran English, Dr. Triveni Arun Akkiraju, a consultant in Obstetrics & Gynecology, Laparoscopy, Fertility, and High-Risk Pregnancy at Hebbal in Bangalore, discussed battling pregnancy challenges with sickle cell disease.
According to Dr. Triveni, pregnancy is a transformative journey, but for women with sickle cell disease (SCD), it presents unique challenges that require comprehensive care. The intersection of SCD and pregnancy heightens the risks of maternal and fetal complications, necessitating meticulous medical management. Sickle cell disease is the most common inherited condition in the world. Most women with SCD will have a straightforward pregnancy and a healthy baby. If you are planning a pregnancy, inform your SCD team so they can review your medication and vaccinations and ensure your check-ups are up-to-date.
You and your partner can meet with a specialist or counselor to discuss the chances of SCD being passed on to your baby and the tests available to you. Women with SCD face an increased risk of preeclampsia, preterm labor, intrauterine growth restriction (IUGR), and low birth weight. Sickle cell crises, characterized by severe pain due to vaso-occlusion, can become more frequent and severe during pregnancy, leading to increased hospitalizations and the need for intensive pain management.
The compounded effects of SCD and pregnancy can exacerbate anemia, causing severe fatigue and increasing the risk of complications for both mother and baby. Infections, such as urinary tract and respiratory infections, pose a higher threat due to the immunocompromised state of women with SCD. The risk of thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is also elevated. Obstetric care for these women involves more frequent and intensive prenatal monitoring, including regular ultrasounds and specialist consultations to mitigate these risks. Delivery complications, including the increased likelihood of caesarean sections, further complicate the birthing process.
Maintaining a healthy diet, hydration, and stress management are also essential for symptom management.(Image Credit:Canva)
The psychological and emotional toll on pregnant women with SCD is significant. The high-risk nature of their pregnancies can lead to profound stress and anxiety, with concerns about their health and their baby’s wellbeing being overwhelming. Chronic pain and frequent hospitalizations can also heighten the risk of depression. Socioeconomic challenges, such as access to comprehensive healthcare and the financial burden of frequent medical visits and specialized care, further complicate their journey.
Dr. Triveni concluded by saying, "To optimize outcomes, a multidisciplinary approach is essential. Enhanced prenatal care, frequent monitoring, and early detection of complications are critical. Safe pain management strategies must be employed to handle sickle cell crises, and while hydroxyurea is typically avoided due to potential teratogenic effects, alternative management strategies, including blood transfusions for severe anemia, are often necessary. The involvement of hematologists, obstetricians, and other specialists ensures comprehensive care. Additionally, providing education about the risks and management strategies, along with psychological support to manage stress and anxiety, is crucial."
Navigating pregnancy with sickle cell disease demands meticulous planning and close collaboration among healthcare providers to ensure the best possible outcomes for both mother and baby.