Sickle cell disease in pregnancy. Obstetric and anesthetic management perspectives.
Recent advances in the pathophysiology, clinical investigations, and management of sickle hemoglobinopathies enables all physicians to better manage these disease states and their sequelae. Patients with sickle cell disease SCD are living longer and are thus more likely to contract unrelated diseases that require surgery and anesthesia. Patients with SCD continue to be a challenge to all branches of medicine particularly in obstetrics, surgery and anesthesia; however, the armamentarium of new knowledge and practice places a different perspective on the care of this old disease. In general, the literature to date suggests that neither prophylactic transfusion of pregnant sicklers nor the selection of an anesthetic in labor have a major impact on patient outcome; however, perioperative management can greatly affect the consequences. A thorough knowledge of the impact of the disease on clinical status can determine how, when, and why to manage parturients with SCD.
Rajab
Khalil E
KE
Department of Obstetrics and Gynecology, College of Medicine and Medical Sciences, Arabian Gulf University and Salmaniya Medical Complex, Bahrain. yonrajab@batelco.com.bh
Skerman
Jonathan H
JH
D000755:Anemia, Sickle Cell / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D000773:Anesthesia, Obstetrical; D001445:Bahrain / Q000453:epidemiology; D001803:Blood Transfusion; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005319:Fetal Hemoglobin / Q000032:analysis; D006239:Haplotypes; D006801:Humans; D011182:Postoperative Care; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011994:Recombinant Proteins; D012720:Severity of Illness Index
D011994:Recombinant Proteins; D004921:Erythropoietin; D005319:Fetal Hemoglobin