Pregnancy outcome in HbSS-sickle cell disease in Lagos, Nigeria

Abstract

A retrospective study of pregnancy outcome in 60 HbSS sickle cell disease patients, exclusively managed in accordance with standard management modality, as obtained in the obstetric Unit of the Lagos University Teaching Hospital (LUTH), was carried out over a 3-year period (1995-1997). The study shows an increase in the number HbSS patients seeking antenatal care in the LUTH. Although the patients maintained a stable haematological profile, all through pregnancy and delivery, as reflected by the booking, pre-delivery and post-delivery PCV of 23.2 +/- SD 4.6% and 23.6 +/- SD 4.5% respectively; pregnancy was complicated in 96.6% of cases (n = 58). Sickle cell crises of bone pain (41.4%), acute haemolysis with anaemia (34.4%); malaria (22.4%) and other systemic infections (22.4%) were the major causes of pregnancy complications. Antenatal and postpartum blood transfusion rates were 45.0% and 81.6% respectively. The perinatal and maternal mortality rates were 121 and 67/1000 respectively, while caesarean section rate was 43.2%. It is observed that while more patients with HbSS sickle cell disease are seeking antenatal care in the LUTH, with improved prognosis, pregnancy complications from sickle cell crisis, remain a major problem in the care of these patients.