Pregnancy outcome in women with sickle cell - a five year review.

OBJECTIVES

To evaluate the cases of sickle cell anaemia in obstetric practice, and to highlight their problems in pregnancy as well as their contribution to maternal and foetal outcome in Nigeria. We believe that the findings would be useful for designing interventions to reduce the obstetric burden of sickle cell disease.

PATIENTS AND MATERIALS

The service delivery record of 42 pregnancies in 39 patients with sickle cell disease was retrospectively reviewed at the University of Benin Teaching Hospital (UBTH) between January 2000 and December 2004.

RESULTS

The incidence of sickle cell disease in the study was 8.7/1000 deliveries. Nearly 62% of the patients were aged 25-34 years, while 76.2% were either nulliparous (Para O) or primiparous (Para 1). There was one grandmultipara (2.38%). Anaemia (95.25%), Malaria (33.33%), Bone pain crisis (23.81%), and pneumonia (19.05%) in that order of frequency were the most common complications of pregnancy. The perinatal mortality rate was 250 per 1000 births while the maternal mortality rate was 47.6 per 1000 pregnancies. At delivery, 20% of cases had caesarean section (5% elective and 15% emergency) and the instrumental interventions include 12.5% vacuum and 27.5% forceps respectively.

CONCLUSION

Early booking, good antenatal care and supervised hospital delivery produced a better obstetric outcome.