TITLE:
Preventive Exchange Blood Transfusion in Pregnant Women with Sickle Cell Disease: Maternal and Perinatal Prognosis in a Country with Limited Resources, Burkina Faso
AUTHORS:
Hyacinthe Zamané, Dantola Paul Kain, Sibraogo Kiemtoré, Abdoul Azize Diallo, Jean Baptiste Valéa, Samba Diallo, Fabienne Sanou, Jean Lankoandé
KEYWORDS:
Sickle Cell Disease, Exchange Transfusion, Maternal and Perinatal Prognosis
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.6 No.6,
May
25,
2016
ABSTRACT: Context: In pregnant women with sickle cell disease, the management with
exchange transfusion could be useful in improving the prognosis of mother and
child by reducing the level of hemoglobin S less than 40%. Objective: To analyze
the maternal and perinatal outcome during the program of the exchange
transfusion in pregnant women with sickle cell disease. Patients and Methods: We
conducted a prospective study over a period of 18 months. Pregnant women with a
major form of sickle cell disease were included. A manual blood exchange
transfusion was performed monthly. We monitored the occurrence of maternal and
perinatal morbidity during the follow-up. Results: A total of 42 pregnant women
with sickle cell disease were monitored. The frequency of infectious episodes
and vaso-occlusive crisis was significantly reduced, respectively from 47.6%
and 83.3% before the beginning of the blood exchanges transfusion to 11.9% and
16.7% during blood exchanges transfusion program. All newborns were alive at
birth with an Apgar score higher or equal to 7 at the 5th minute.
The rate of admission of the newborns at neonatal intensive care unit was 9.3%.
Maternal mortality was estimated at 7.1% and there was no early neonatal mortality.
Conclusion: Prophylactic exchange transfusion reduces infections and the
reoccurrence of vaso-occlusive crisis, which has an impact on perinatal
prognosis.