Sickle hemoglobin and the gravid patient: a management controversy.

It is evident that patients with sickle cell disease are now in an era when they can safely complete a pregnancy with a reasonable expectation of a good outcome for both the mother and baby. Although there are vast disagreements as to which techniques (both diagnostic and therapeutic) to employ, the use of individualized methods in various geographic areas will yield the best result. To conclusively answer the questions raised in this article, a large multi-center collaborative study must be performed. If randomized treatment regimens of "transfusion versus no transfusion" were carried out in such a study, the true risk of both approaches could be assessed. Moreover, with adequate follow-up studies many of the risks of each type of treatment could be evaluated. Only through such a large study will these controversies be resolved.