Continued from Managing Sickle Cell In Pregnancy 1
Pregnant women with Sickle Cell Trait are at greater risks of frequent urinary tract infections and developing iron-deficiency anemia than other pregnant women and will require iron supplementation, but they have no extra risks associated with being a carrier.
Women with Sickle Cell Disease are more likely to have life-threatening complications during pregnancy, which may include crises, infection (e.g., pyelonephritis, pneumonia, sepsis, postpartum infection), preeclampsia, cerebral vein thrombosis, pulmonary embolus, deep vein thrombosis (DVT), cholelithiasis (i.e., gallstones), cholecystitis (i.e., inflammation of the gallbladder), cardiomegaly (enlarged heart), myocardial infarction (MI), heart failure, or postpartum hemorrhage (bleeding). Pre-existing renal disease or heart failure secondary to SCD may worsen during pregnancy. Anemia and circulatory problems in SCD can result in less oxygen delivered to the fetus, resulting in miscarriage, slower fetal growth, stillbirth, and neonatal death. Fetal complications include intrauterine growth restriction (IUGR), preterm birth (prior to 37 weeks of gestation), and low birthweight. These risks are also present in women without SCD, it’s just that women with SCD are at a higher risk for developing said complications.
Early and regular prenatal care is essential for close maternal and fetal monitoring when managing pregnancy with sickle cell disease. General pregnancy care includes a healthy diet, low-impact light exercise, prenatal vitamins, folic acid, increased fluid intake, and prompt treatment of infections and crises. Blood transfusions to replace abnormal cells with normal ones in order to improve the blood’s oxygen-carrying capacity may be required for women with a history of frequent SCD crises. Getting too much IV fluids during pregnancy may lead to heart failure, so be sure not to get more than 3 Liters day if you are going to get intravenous fluids. During labor, a woman with SCD will receive extra oxygen.
It is important that you practice good self-care during your pregnancy. Exercise. Hydrate. Rest. Eat Healthy. These are all tips that you should be incorporating into your life anyway, and while pregnant, you should be hyper-vigilant to prevent a crisis and help your baby grow. If you do have a crisis while pregnant, call your doctor right away, as medical interventions may be required to support your baby’s health. If you are having multiple crises, ask for a neonatal specialist to help monitor your babies’ health in the womb. Become best buds with your OBGYN, and as a further precaution, get a high risk OBGYN that can help you during your transition into motherhood. Continue to see your Hematologist and other physicians as required. Remember, your baby is only as healthy as you are.
Written by Tosin, Sickle Cell Warrior
Culled from Sickle Cell Warriors.