Centre National de transfusion Sanguine de Bamako, Bamako, Mali.
Centre de recherche et de Lutte contre la Drépanocytose, Bamako, Mali.
Transfus Med. 2024 Oct;34(5):421-427. doi: 10.1111/tme.13074. Epub 2024 Aug 5.
Pregnancy in women with sickle cell disease (SCD) is associated with severe complications. Red blood cell (RBC) alloimmunisation is a worrying situation in pregnant women with SCD. This could increase the difficulty in finding a pheno-compatible red blood product. Our study aimed to determine the prevalence of RBC alloantibodies in pregnant women with SCD and to determine the risk factors for alloantibodies formation.
METHODS/MATERIALS: We conducted a prospective study at the "Centre National de Transfusion Sanguine de Bamako" from August 2022 to January 2023. For each participant, we collected important information, including obstetrical and transfusion histories. We performed ABO group, Rh and Kell phenotyping, and antibody screening in all study participants. We performed statistical analysis.
We recruited 95 pregnant women with SCD. In our study, 62% of our participant had a history of blood transfusion. Only 23% of our pregnant women with SCD had a history of miscarriage. The prevalence of RBC alloantibodies was 14%. The main antibodies detected were anti-E (38%) and pan-agglutinins (23%). Miscarriage history, blood transfusion history, and pregnancy number were the main risk factors for RBC alloimmunisation.
The care of pregnant women with SCD is complex and requires collaboration between haematologists, clinicians and gynaecologists. National guidelines should be implemented to make ABO and D typing, Rh and Kell phenotyping and antibody screening routine for all pregnant women. This would facilitate early detection of high-risk situations. Particular attention should be paid to SCD pregnant women with miscarriage and blood transfusion histories.
患有镰状细胞病 (SCD) 的女性怀孕会伴随严重并发症。红细胞 (RBC) 同种免疫是 SCD 孕妇令人担忧的情况。这可能会增加找到表型相容的红细胞产品的难度。我们的研究旨在确定 SCD 孕妇 RBC 同种抗体的流行率，并确定同种抗体形成的危险因素。
方法/材料：我们于 2022 年 8 月至 2023 年 1 月在“巴马科国家血液中心”进行了一项前瞻性研究。对于每一位参与者，我们收集了重要信息，包括产科和输血史。我们对所有研究参与者进行 ABO 组、Rh 和 Kell 表型以及抗体筛查。我们进行了统计分析。
我们招募了 95 名患有 SCD 的孕妇。在我们的研究中，62%的参与者有输血史。仅有 23%的 SCD 孕妇有流产史。RBC 同种抗体的流行率为 14%。主要检测到的抗体是抗-E（38%）和全凝集素（23%）。流产史、输血史和妊娠次数是 RBC 同种免疫的主要危险因素。
SCD 孕妇的护理复杂，需要血液科医生、临床医生和妇科医生共同协作。应实施国家指南，使 ABO 和 D 定型、Rh 和 Kell 表型以及抗体筛查成为所有孕妇的常规检查。这将有助于早期发现高危情况。应特别关注有流产和输血史的 SCD 孕妇。
