Pregnancy can present unique challenges for women with Sickle Cell Disease, but with careful planning and specialized care, a healthy pregnancy and delivery are possible. This blog post will provide a comprehensive overview of the considerations for women with SCD who are pregnant or planning to become pregnant, including potential risks, management strategies, and tips for a successful pregnancy.
Risks and Complications During Pregnancy:
- Increased Pain Crises: Pregnancy can increase the frequency and severity of pain crises.
- Worsening Anemia: Anemia can worsen during pregnancy, leading to fatigue and other complications.
- Increased Risk of Infections: Pregnant women with SCD are more susceptible to infections.
- Preeclampsia: A serious condition characterized by high blood pressure and protein in the urine.
- Eclampsia: A life-threatening complication of preeclampsia that causes seizures.
- Preterm Labor and Delivery: Giving birth before 37 weeks of pregnancy.
- Low Birth Weight: Babies born to mothers with SCD may have a lower birth weight.
- Intrauterine Growth Restriction (IUGR): The fetus does not grow as expected in the womb.
- Stillbirth: Pregnancy loss after 20 weeks.
- Blood Clots: Increased risk of developing blood clots in the legs or lungs.
- Pulmonary Hypertension: Having high blood pressure in the blood vessels of your lungs
- Acute Chest Syndrome: More likely to develop acute chest syndrome during pregnancy.
Sickle Cell doesn’t define you, it fuels your strength. Keep shinning, keep thriving.
HELEN B.
Preconception Counseling and Planning:
- Consult a Hematologist and Obstetrician: It’s crucial to discuss your plans for pregnancy with a hematologist (specialist in blood disorders) and an obstetrician who has experience managing high-risk pregnancies. Ideally, a maternal-fetal medicine specialist should be part of your care team.
- Genetic Counseling: Discuss the risks of passing on SCD to your child and consider genetic testing for your partner.
- Optimize Health: Before becoming pregnant, it’s important to be in the best possible health. This includes:
- Managing your SCD effectively
- Taking folic acid supplements
- Getting vaccinated
- Achieving a healthy weight
- Stopping smoking
- Review Medications: Discuss all medications you are taking with your doctor, as some may need to be adjusted or discontinued during pregnancy.
- Hydroxyurea: Hydroxyurea is generally not recommended during pregnancy.
Prenatal Care and Management:
- More Frequent Prenatal Visits: You will likely need more frequent prenatal visits than women without SCD.
- Close Monitoring: Your health and the baby’s growth and development will be closely monitored throughout the pregnancy.
- Ultrasound Scans: Regular ultrasounds will be performed to assess the baby’s growth and well-being.
- Non-Stress Tests and Biophysical Profiles: These tests monitor the baby’s heart rate and movements.
- Blood Tests: Regular blood tests will be done to monitor your hemoglobin levels, check for infections, and assess your overall health.
- Folic Acid Supplementation: Higher doses of folic acid are often recommended during pregnancy.
- Pain Management: Develop a plan with your doctor for managing pain crises during pregnancy.
- Blood Transfusions: You may need blood transfusions during pregnancy to treat severe anemia or other complications.
- Low-dose Aspirin: May be prescribed to reduce the risk of preeclampsia.
- Antibiotics: May be given to prevent or treat infections.
Labor and Delivery:
- Hospital Birth: It’s recommended that women with SCD give birth in a hospital with a specialized team experienced in managing high-risk pregnancies.
- Pain Management: Various pain management options are available during labor, including epidural anesthesia.
- Continuous Fetal Monitoring: The baby’s heart rate will be continuously monitored during labor.
- Cesarean Section: A Cesarean section may be necessary in some cases.
- Blood Transfusion: You may be crossmatched for blood in case you need a blood transfusion.
Postpartum Care:
- Close Monitoring: You and your baby will be closely monitored after delivery.
- Pain Management: Continue to manage pain as needed.
- Breastfeeding: Breastfeeding is generally encouraged, but discuss this with your doctor, especially if you are taking medications.
- Contraception: Discuss contraception options with your doctor if you are not planning another pregnancy soon.
- Continued Hydroxyurea Use: Your doctor will discuss whether you should continue taking this medication or not after delivery.
Conclusion: Pregnancy with Sickle Cell Disease requires careful planning, specialized care, and close monitoring. By working closely with a team of healthcare professionals and taking proactive steps to manage your health, you can increase your chances of having a healthy pregnancy and a healthy baby.
