Morrison J C, Schneider J M, Whybrew W D, Bucovaz E T, Menzel D M
Obstet Gynecol. 1980 Sep;56(3):274-80.
Pregnancy in patients with sickle cell disease has been a significant threat to maternal survival and good reproductive outcome. In the past several years, statistics for both maternal and perinatal outcome have improved. There is controversy, however, as to whether this improvement has resulted from the use of maternal transfusions or the aggressive and intense medical management afforded these patients in recent years. This study details the reproductive experience of 80 pregnant patients with significant hemoglobinopathies, 75 of whom were treated with partial prophylactic exchange transfusions during gestation. Each of the 75 patients who completed the protocol received 2 transfusions using buffy coat-poor washed packed red cells. The results show that there was no maternal mortality and a significant improvement in maternal morbidity compared to previous studies. There was also a significant improvement in fetal salvage, with a perinatal mortality rate of 26 per 1000. In addition, there were fewer premature and low birth weight infants as compared to other studies in the literature. Although these results were favorable, only a randomized multicentered study in the future will detail advantages and disadvantages of such therapy in the gravid sickle cell patient compared to intensive medical treatment without transfusion.
镰状细胞病患者怀孕一直对孕产妇生存及良好的生殖结局构成重大威胁。在过去几年中，孕产妇和围产期结局的统计数据有所改善。然而，对于这种改善是源于孕产妇输血的使用，还是近年来为这些患者提供的积极且强化的医疗管理，仍存在争议。本研究详细介绍了80例患有严重血红蛋白病的孕妇的生殖经历，其中75例在妊娠期接受了部分预防性换血输血治疗。完成方案的75例患者中的每一位都使用去除白细胞的洗涤浓缩红细胞接受了2次输血。结果显示，与既往研究相比，孕产妇无死亡，孕产妇发病率有显著改善。胎儿挽救情况也有显著改善，围产期死亡率为每1000例中有26例。此外，与文献中的其他研究相比，早产和低出生体重婴儿较少。尽管这些结果是有利的，但未来只有一项随机多中心研究才能详细说明与不输血的强化医疗治疗相比，这种疗法在镰状细胞病妊娠患者中的优缺点。
