Imran Iffat, Nazir Imran, Rfaai Rakan Tariq J Al, Khalil Khalid
Iffat Imran Consultant Gynecologist, College of Medicine, Taif University, Taif, Saudi Arabia.
Imran Nazir University Medical and Dental College, Faisalabad.
Pak J Med Sci. 2025 Jan;41(1):44-48. doi: 10.12669/pjms.41.1.9783.
To observe the fetomaternal outcome of therapeutic versus prophylactic blood transfusions in patients with sickle cell disease (SCD) during pregnancy.
This single-center retrospective observational study was conducted on consecutive pregnant women with SCD between January 2018 and December 2020. All the pregnant women with SCD were included in this study. Sickler women carrying sickle cell traits (HbAS, HbAC), multiple pregnancy, or other medical diseases were excluded from the study. We used non-random, convenience sampling and collected their demographic details, medical history, course of SCD before & during pregnancy, maternal/fetal outcome, laboratory parameters, and other information using the questionnaire. Patients were sub-grouped into three according to blood transfusion categories (therapeutic, prophylactic, or not transfused) during the pregnancy. Descriptive data were represented as numbers and mean ± SD values. The medical and obstetrical complications and fetomaternal outcomes among the three groups were analyzed by Chi-square/Fisher's Extract test.
The study included 62 patients, 37 were in the therapeutic group, 11 were in the prophylactic group, and 14 were in the non-transfusion group. Hemolytic crises, painful crises, acute chest syndrome, pregnancy-induced hypertension (PIH), preeclampsia, preterm births, intrauterine growth retardation (IUGR), and neonatal ICU admission were significantly lower among the prophylactic group (P = 0.000, p = 0.000, p = 0.001, p = 0.002, p = 0.009, p = 0.007, p =0.001 & p= 0.016 respectively) compared with other two groups.
Our study demonstrates that prophylactic blood transfusion in SCD positively alters the course of pregnancy by reducing fetomaternal complications.
观察镰状细胞病（SCD）患者孕期治疗性输血与预防性输血的母婴结局。
本单中心回顾性观察研究针对2018年1月至2020年12月期间连续的SCD孕妇开展。所有SCD孕妇均纳入本研究。携带镰状细胞性状（HbAS、HbAC）、多胎妊娠或患有其他疾病的孕妇被排除在研究之外。我们采用非随机便利抽样方法，通过问卷收集她们的人口统计学细节、病史、孕期前后的SCD病程、母婴结局、实验室参数及其他信息。根据孕期输血类别（治疗性、预防性或未输血）将患者分为三组。描述性数据以数字和均值±标准差表示。通过卡方检验/费舍尔精确检验分析三组间的医学和产科并发症及母婴结局。
本研究纳入62例患者，治疗组37例，预防组11例，未输血组14例。预防组的溶血危象、疼痛危象、急性胸综合征、妊娠期高血压（PIH）、子痫前期、早产、宫内生长受限（IUGR）及新生儿重症监护病房收治率均显著低于其他两组（分别为P = 0.000、p = 0.000、p = 0.001、p = 0.002、p = 0.009、p = 0.007、p = 0.001及p = 0.016）。
我们的研究表明，SCD患者孕期预防性输血可通过减少母婴并发症积极改变妊娠进程。
