Lagro M G P, Rijneveld A W, Duvekot J J
Erasmus MC-Centrum, afd. Verloskunde en Vrouwenziekten, subdivisie Verloskunde en Prenatale Geneeskunde, Postbus 2040, 3000 CA Rotterdam.
Ned Tijdschr Geneeskd. 2008 Aug 9;152(32):1753-6.
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 nonpregnant 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.
三名患有镰状细胞病的女性在孕期住院。第一名患者,26岁,孕23周时因镰状细胞危象入院;随后她出现了先兆子痫并伴有胎儿生长受限。妊娠终止后,24周时娩出一死胎。胎盘组织病理学检查显示多处梗死,可能由镰状细胞病所致。第二名患者,22岁,接受了镰状细胞危象和早产的治疗。她在29周时剖宫产娩出一对健康双胞胎。术后,急性胸综合征采用抗生素和红细胞单采术进行治疗。第三名患者,25岁,产后因多发性静脉血栓栓塞事件接受治疗。镰状细胞相关并发症在孕妇和非孕妇中的处理方式相同。我们建议在受孕前为患有镰状细胞病的女性提供咨询,并对其伴侣进行血红蛋白病检测。患有镰状细胞病的孕妇需要包括产科医生、血液科医生、新生儿科医生和麻醉科医生在内的多学科团队提供的专业护理。