PREGNANCY IN HOMOZYGOUS SICKLE‐CELL ANAEMIA

Abstract

Summary In 12 years (1958–69) 38 patients with homozygous sickle‐cell anaemia (SS) were studied during the course of 61 pregnancies. Maternal prognosis was poor, with 7 deaths. The causes of mortality and morbidity were severe anaemia, acute sequestration, bacterial infections, bone pain crises, and bone marrow embolism. The proportion of these patients requiring operative deliveries was high chiefly because of fetopelvic disproportion from generally contracted pelvis. For obstetric operations various types of anaesthesia were used with excellent results, provided gross anaemia was corrected and hypoxia was avoided. When bone pain crises occurred during late pregnancy, labour and in the early puerperium, heparinization and blood transfusions were freely used. Fertility was reduced in these women, and both the spontaneous abortion rate and fetal wastage were at least twice as high as they were in the general population. The average birthweight of the babies was comparatively low, for no obvious reasons.