Fertility Issue and Pregnancy in Patient with Sickle Cell Disease
With improvements in healthcare, most women with sickle cell disease (SCD) are surviving into adulthood. Some women with SCD have difficulty conceiving, while others can get pregnant. In both high- and low-resource settings, pregnant women with SCD are predisposed to increased odds of adverse maternal and perinatal outcomes. These adverse maternal and perinatal outcomes could be either SCD-related, obstetrics-related, or both. Comorbidities for women with SCD include increased odds of antenatal hospitalizations for acute pain, acute chest syndrome (ACS), venous thromboembolism (VTE), severe anemia, spontaneous abortions, intrauterine growth restriction (IUGR), intrauterine fetal death (IUFD), perinatal death, preeclampsia, and maternal death. With multidisciplinary SCD obstetrics care, pregnancy outcomes in women with SCD are improved. This chapter highlights essential pregnancy and fertility issues in women with SCD. In the absence of randomized controlled trials, we provide data to support optimal strategies regarding options for preconception care, antepartum care, labor and delivery, and management of SCD-related complications during pregnancy.
