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PubMed · 831388

Hemoglobinopathies in pregnancy.

J C Jennings
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Abstract

Sickle cell trait is associated with an increased incidence of asymptomatic bacteriuria, low birth weight infants and premature rupture of membranes. Hemoglobin SS and hemoglobin SC in pregnancy result in significantly increased maternal morbidity and mortality and reproductive wastage. Heterozygous thalassemias in pregnancy carry increased risks but to a lesser degree than hemoglobins SS and SC. Partial exchange transfusion can provide effective prophylaxis for many of the maternal and fetal problems of sickle cell disease.

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Anemia, Sickle CellExchange Transfusion, Whole BloodFemaleHemoglobin C DiseaseHemoglobinopathiesHemoglobins, AbnormalHumansPregnancyPregnancy Complications, HematologicSickle Cell TraitThalassemiaJournal Article

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J C Jennings. 1977. Hemoglobinopathies in pregnancy.. https://pubmed.ncbi.nlm.nih.gov/831388/

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Prophylactic transfusions of normal red blood cells during pregnancies complicated by sickle cell hemoglobinopathies.

Prophylactic transfusions of normal donor red cells were administered during 37 pregnancies to women with sickle cell anemia, sickle cell-hemoglobin C disease, or sickle cell-beta thalassemia disease. Once the diagnosis was confirmed, the transfusions were administered intermittently throughout the rest of the pregnancy in such amounts and at such frequencies that no more than 60% of the circulating red cells contained hemoglobin S and the hematocrit was above 25. The maternal mortality rate was zero and maternal morbidity as the consequence of the sickle cell hemoglobinopathy was minimal. The perinatal mortality rate was appreciably reduced when compared to that previously observed without prophylactic transfusions but perinatal morbidity was still excessive. Evidence that the intrauterine environment was compromised, in spite of the transfusions consisted of an increased frequency of growth-retarded fetuses, of meconium staining of amnionic fluid, and of ominous decelerations of fetal heart rate. Morbidity from the transfusions was troublesome. Nonetheless, it is concluded tentatively that both the mother with a sickle cell hemoglobinopathy and her fetus are likely to benefit from prophylactic transfusions of normal donor red cells administered during one pregnancy according to the protocol employed in this study.

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