Скачать или смотреть Evidence-based Management of Sickle Cell in Pregnancy by Prof. Bosede Afolabi

Sickle cell disease (SCD) poses unique challenges during pregnancy, requiring evidence-based management strategies to ensure the well-being of both the mother and the unborn child. Here's a concise overview of evidence-based practices in managing sickle cell disease during pregnancy:

1. Preconception Counseling:

Evidence: Studies highlight the importance of preconception counseling for women with sickle cell disease to address potential risks and optimize health before pregnancy.
Management: Healthcare providers should counsel women on the impact of SCD on pregnancy, potential complications, and the importance of maintaining overall health.
2. Comprehensive Monitoring:

Evidence: Regular monitoring, including hematological assessments, is crucial for identifying potential complications early.
Management: Implement a comprehensive monitoring plan, including regular blood tests, fetal ultrasounds, and other assessments, to detect and address any issues promptly.
3. Hydroxyurea Therapy:

Evidence: Some studies suggest that hydroxyurea, a medication that increases fetal hemoglobin, may reduce pregnancy complications in women with SCD.
Management: Consideration of hydroxyurea therapy during pregnancy should be individualized, weighing potential benefits against risks, and closely monitored.
4. Blood Transfusions:

Evidence: Transfusions are employed to prevent or manage complications such as anemia and reduce the risk of sickle cell-related crises.
Management: Blood transfusions may be recommended based on the severity of the disease and associated complications. Close monitoring for potential complications is essential.
5. Pain Management:

Evidence: Effective pain management is critical in preventing and alleviating vaso-occlusive crises associated with SCD.
Management: Individualized pain management plans should be established, considering the potential impact on both maternal and fetal well-being.
6. Prophylactic Antibiotics:

Evidence: Antibiotics are commonly used to prevent infections, a significant concern in individuals with sickle cell disease.
Management: Prophylactic antibiotics may be prescribed during pregnancy to reduce the risk of infections.
7. Cesarean Section Considerations:

Evidence: The mode of delivery is a critical consideration to minimize the risk of complications.
Management: While vaginal delivery is often preferred, cesarean section may be recommended in certain cases to reduce the risk of maternal and fetal complications.
8. Genetic Counseling:

Evidence: Genetic counseling is essential to inform couples about the risk of passing SCD to their offspring.
Management: Offer genetic counseling to individuals and couples to help them make informed decisions about family planning.
9. Multidisciplinary Approach:

Evidence: A multidisciplinary approach involving obstetricians, hematologists, and other specialists is associated with improved outcomes.
Management: Collaborative care ensures comprehensive management, addressing both the obstetric and hematologic aspects of sickle cell disease in pregnancy.

evidence-based management of sickle cell disease in pregnancy involves a personalized and multidisciplinary approach. Regular monitoring, individualized therapies, and a focus on preventive measures are crucial for optimizing outcomes for both the mother and the baby. Close collaboration between healthcare providers and pregnant individuals with SCD is key to achieving successful pregnancies while minimizing complications.