Cardosa Deyna, Ridout Alexandra, Nanda Surabhi, Howard Jo, Robinson Susan E, Oteng-Ntim Eugene
a Department of Haematology , Southwark Wing, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust , London , UK.
b Women's Health, St Thomas' Hospital, Guy's and St. Thomas' NHS Foundation Trust , London , UK.
Hematology. 2019 Dec;24(1):148-158. doi: 10.1080/10245332.2018.1535534. Epub 2018 Oct 21.
Maternal sickle cell disease (SCD) and multiple gestations are well known separately as causes of high-risk pregnancies, however, there is sparse information available on maternal and perinatal outcome when both conditions occur together. This case series describes the outcomes of women with maternal SCD and twin pregnancy in the largest single-center case series to date.
Retrospective identification of all twin pregnancies in maternal SCD patients between 2006 and 2016 at Guy's and St. Thomas' Hospital, United Kingdom Results: Eight women were included: seven with HbSS and one with HbSC. Our cohort experienced common SCD-related and pregnancy-related complications such as painful vaso-occlusive crises (VOC), acute chest syndrome (ACS), and pre-eclampsia and less common complications such as peri-partum cardiomyopathy and delayed hemolytic transfusion reaction. Only two out of eight women had relatively uncomplicated pregnancies. Seven out of eight women required transfusion antenatally and there was no maternal or perinatal mortality. A review of the available literature highlighted the lack of available information on this uncommon cohort. It was evident that outcomes have improved over the years, where historical studies demonstrate higher rates of maternal and perinatal mortality.
The antenatal and postnatal complications described in our study and literature review highlights the significant morbidity and mortality associated with these high-risk pregnancies.
Our case series highlights the advantage of closer monitoring and comprehensive multidisciplinary care in delivering improved clinical outcomes.
母亲镰状细胞病（SCD）和多胎妊娠分别是众所周知的高危妊娠原因，然而，关于这两种情况同时出现时的孕产妇和围产期结局，可用信息稀少。本病例系列描述了迄今为止最大的单中心病例系列中患有母亲SCD和双胎妊娠的女性的结局。
对2006年至2016年期间英国盖伊和圣托马斯医院母亲SCD患者中的所有双胎妊娠进行回顾性识别。结果：纳入8名女性：7名患有HbSS，1名患有HbSC。我们的队列经历了常见的SCD相关和妊娠相关并发症，如疼痛性血管闭塞危象（VOC）、急性胸综合征（ACS）和先兆子痫，以及较少见的并发症，如围产期心肌病和迟发性溶血性输血反应。8名女性中只有2名妊娠相对无并发症。8名女性中有7名在产前需要输血，且无孕产妇或围产期死亡。对现有文献的回顾突出了关于这一罕见队列的可用信息匮乏。很明显，多年来结局有所改善，以往的研究显示孕产妇和围产期死亡率更高。
我们的研究和文献综述中描述的产前和产后并发症突出了与这些高危妊娠相关的显著发病率和死亡率。
我们的病例系列突出了密切监测和全面多学科护理在改善临床结局方面的优势。
