Zwangerschap en sikkelcelziekte: een combinatie met potentieel ernstige complicaties

- Three women with sickle cell disease were hospitalised during pregnancy. The first patient, 26 years old, was admitted with a sickle cell crisis at a gestational age of 23 weeks; she subsequently developed preeclampsia with foetal growth retardation. A stillborn foetus was delivered at 24 weeks after termination of pregnancy. Histopathology of the placenta showed multiple infarctions possibly due to sickle cell disease. The second patient, 22 years old, was treated for sickle cell crisis and preterm labour. She delivered healthy twins at 29 weeks by Caesarean section. Postoperatively, an acute chest syndrome was treated with antibiotics and erythrocytapheresis. The third patient, 25 years old, was treated post partum for multiple venous thromboembolic events. Management of sickle cell-related complications is the same in pregnant and non-pregnant women. We recommend counselling women with sickle cell disease prior to conception and testing partners for haemoglobinopathy. The pregnant sickle cell patient needs specialised care from a multidisciplinary team including obstetricians, haematologists, neonatologists and anaesthesiologists.

Ned Tijdschr Geneeskd. 2008;152:1753-6