Cunningham F G, Pritchard J A, Mason R
Obstet Gynecol. 1983 Oct;62(4):419-24.
Maternal morbidity and perinatal outcome in 108 pregnancies complicated by sickle cell anemia (hemoglobin SS disease), sickle cell-hemoglobin C disease (hemoglobin SC disease), or sickle cell-beta-thalassemia disease were analyzed. Women given prophylactic red cell transfusions (1973-1982) during pregnancy were matched with historic controls whose care was almost identical except that blood was not given unless indicated (1955 to 1972). In women with hemoglobin SS disease who received prophylactic red cell transfusions, there was a sevenfold reduction in perinatal mortality and negligible maternal morbidity. In pregnancies complicated by hemoglobin SC disease during which transfusions were given, there were no perinatal losses, whereas there were in 18% of women not given transfusions. Maternal morbidity in women given transfusions was negligible; however, half of those not transfused experienced morbidity and, importantly, pulmonary complications were common. Transfusion-related complications included hepatitis and alloimmunization. From these experiences the authors conclude that prophylactic red cell transfusions reduce maternal morbidity and perinatal mortality appreciably, although perinatal morbidity is not eliminated. Transfusion therapy is justifiably started early in pregnancy for women with hemoglobin SS disease; however, transfusions may be withheld until the end of the second trimester for women with hemoglobin SC or sickle cell-beta-thalassemia disease.
对108例合并镰状细胞贫血（血红蛋白SS病）、镰状细胞-血红蛋白C病（血红蛋白SC病）或镰状细胞-β地中海贫血病的妊娠产妇的发病情况及围产期结局进行了分析。将孕期接受预防性红细胞输血的女性（1973 - 1982年）与历史对照进行匹配，这些对照的护理情况几乎相同，只是除非有指征否则不输血（1955年至1972年）。在接受预防性红细胞输血的血红蛋白SS病女性中，围产期死亡率降低了7倍，产妇发病率可忽略不计。在合并血红蛋白SC病且接受输血的妊娠中，没有围产期死亡，而未接受输血的女性中有18%出现围产期死亡。接受输血的女性产妇发病率可忽略不计；然而，未输血的女性中有一半出现发病情况，重要的是，肺部并发症很常见。输血相关并发症包括肝炎和同种免疫。基于这些经验，作者得出结论，预防性红细胞输血可显著降低产妇发病率和围产期死亡率，尽管围产期发病率并未消除。对于血红蛋白SS病女性，在妊娠早期就有理由开始输血治疗；然而，对于血红蛋白SC或镰状细胞-β地中海贫血病女性，输血可推迟至妊娠中期结束。
