Sickle Cell Disease in Pregnancy: Maternal and Fetal Outcome in Port Harcourt, Nigeria

Background: Medical experts for many years have daunted the occurrence of pregnancy in homozygote sickle cell patients. This is because of associated high risk for mother and fetus.
The aim of this study is to determine the prevalence and maternal and fetal outcome of pregnant mothers with sickle cell disease at the University of Port Harcourt Teaching Hospital, Nigeria.
Materials and Methods: This was a retrospective descriptive study of medical case files of all booked pregnant mothers who attended the antenatal clinic of the University of Port Harcourt Teaching Hospital, Nigeria from January 2007 to December 2011. The parameters extracted from the folders included: age, level of education, hemoglobin genotype, full blood count, malaria parasite, urine analysis and culture, complications of pregnancy, Apgar scores and birth weight.
Results: A total of 4,650 mothers were booked for antenatal care. Eight hundred and forty (18.1%) of them were HbAS, five (0.1%) were HbAC, nine (0.2%) were HbSS and 1(0.02%) HbSC. Age and gestation at booking were 18–42 years (mean 28.6± 2.1) and 9–34 weeks gestation (mean 16.6±3.3), respectively. Malaria and vaso-occlusive crisis were the commonest complications encountered in pregnancy. Twenty percent of women had induction of labour and 60% were delivered by emergency caesarean section. Twenty percent had postpartum haemorrhage. Forty four percent of women delivered before 37 completed weeks. Birth weight below 2500 g occurred in 50% of singleton pregnancies. Two neonates developed transient complications related to maternal opiate exposure postnatally. There were 2(20%) maternal and fetal losses from toxaemia of pregnancy.
Conclusion: Pregnancy is uncommon among females with sickle cell disease in Port Harcourt, Nigeria. Sickle cell disease remains a severe complicating factor to pregnancy and associated with increased fetal and maternal losses.