ByZarafshan Shiraz, New Delhi

Sickle cell illness is broadly prevalent in sure elements of India and whereas this health situation may cause a large spectrum of signs, improvements in administration have reworked this situation. For the uninitiated, Sickle Cell Disease (SCD) is a genetic situation the place the purple blood cells change into formed like crescents or sickles, which may trigger varied well being issues.

In an interview with HT Lifestyle, Dr Santanu Sen, Consultant, Paediatric Hematology, Oncology and Stem Cell Transplantation at Kokilaben Dhirubhai Ambani Hospital Mumbai, talked about what's the Impact of Sickle Cell Disease on Pregnancy and Maternal Health and shared, “For pregnant women with SCD, the condition adds an extra layer of complexity to the pregnancy. These mothers-to-be may experience increased pain episodes, infections, and high blood pressure. The irregular shape of the red blood cells can obstruct blood flow, potentially leading to complications such as preterm birth and low birth weight in newborns, miscarriages and even spontaneous abortions.”

She added, “SCD poses risks to the mother's health; there can be severe anaemia leading to fatigue, shortness of breath and even fetal anaemia. In addition, there is an elevated risk of blood clots and pulmonary issues, such as acute chest syndrome as well as increased incidence of strokes. Chances of preeclampsia due to high blood presseure is also very high. It is essential for pregnant women with SCD to be under the care of healthcare professionals who are knowledgeable about the condition. Through vigilant monitoring and proper management, both the mother and baby can be safeguarded during this critical period. If a patient has severe sickle cell disease, a stem cell transplant can be curative.”

According to Dr Amita Mahajan, Senior Consultant, Paediatrics Oncology and Hematology at Indraprastha Apollo Hospital in New Delhi, being pregnant can pose few challenges to sufferers with sickle cell illness like -

• Increased Risk of Complications: Pregnant girls with SCD face the next threat of issues in comparison with the overall inhabitants. The irregular sickle-shaped purple blood cells can hinder blood vessels, resulting in vaso-occlusive crises, which may happen throughout being pregnant. These crises can manifest as extreme ache, organ harm, and even life-threatening circumstances, equivalent to acute chest syndrome. Furthermore, pregnant girls with SCD are extra vulnerable to infections, anemia, and pre-eclampsia, which may complicate their pregnancies and endanger maternal and fetal well-being.
• Maternal Mortality and Morbidity: Women with SCD have an elevated threat of maternal mortality in comparison with girls with out the situation. The mixture of pre-existing issues and the physiological modifications that happen throughout being pregnant can exacerbate the well being dangers. Anemia, which is widespread in SCD, can worsen throughout being pregnant attributable to elevated blood quantity necessities. This locations a further pressure on the already compromised oxygen-carrying capability of the blood, doubtlessly resulting in maternal morbidity and mortality. Timely and applicable medical interventions, together with blood transfusions and shut monitoring, are very important in mitigating these dangers.
• Fetal and Neonatal Complications: SCD additionally poses dangers to the creating fetus and the neonate. Maternal issues, equivalent to vaso-occlusive crises or pre-eclampsia, can instantly have an effect on fetal well-being. Poor placental perfusion and oxygenation can result in intrauterine progress restriction and low start weight. Additionally, the presence of SCD will increase the possibility of the fetus inheriting the illness, with implications for the kid's future well being. Early and correct prenatal analysis, together with applicable counseling and assist, are important in managing these potential issues.
• Comprehensive Care and Management: Comprehensive take care of pregnant girls with SCD requires a multidisciplinary strategy. This consists of shut collaboration between obstetricians, hematologists, genetic counselors, and different healthcare professionals. Preconception counseling and training are essential to assist girls make knowledgeable choices about being pregnant and to optimize their well being earlier than conception. Regular prenatal visits, together with specialised monitoring, can assist detect and handle issues promptly. Pain administration methods, blood transfusions and hydroxyurea remedy could also be utilized to attenuate crises and preserve maternal well-being.
• Supportive Measures and Education: Psychosocial assist and affected person training play an important position in managing SCD throughout being pregnant. Women with SCD face bodily, emotional, and social challenges, and a supportive community can assist alleviate a few of the burdens. Education about self-care, ache administration methods, and the significance of remedy adherence can empower girls to take an lively position of their well being. Additionally, elevating consciousness amongst healthcare suppliers and the overall inhabitants concerning the distinctive wants of pregnant girls with SCD is essential for bettering outcomes and lowering stigma.