Overview:
A woman with sickle cell anemia can get pregnant naturally, but it is important to consult a doctor before planning a pregnancy for a sufficient period of time, to pass the pregnancy stage with the least number of complications, and it is also necessary to know whether the husband is a carrier of the disease or not; To find out the extent to which the fetus is susceptible to the disease.
Mandatory examinations before embarking on pregnancy:
- Comprehensive examination by the attending physician.
- Examine and monitor blood pressure closely.
- A blood test, specifically the level of hemoglobin.
- Electrocardiography and imaging of the heart (sonar).
- Kidney analysis and urine albumin examination.
- Examination of the retina by the specialist.
Treatment during pregnancy:
- Women infected with it often have exposure to bacterial infections, which forces them to take antibiotics continuously, so it is important to see a doctor before planning a pregnancy, and to make sure that medications do not interfere with pregnancy.
- When taking hydroxyurea regularly, it must be stopped before 3 months of pregnancy or as soon as pregnancy is known, and the doctor should be asked about safe alternatives thereto.
- Angiotensin converting enzyme inhibitors and angiotensin receptor blockers should be discontinued prior to pregnancy.
- Take a high dose of folic acid (5 mg) daily throughout pregnancy period to strengthen blood cells.
- Take low-dose aspirin (75 milligrams) daily during pregnancy. To reduce the risk of preeclampsia.
- Pain relievers (e.g.: paracetamol) can be taken.
- Avoid pain relievers (such as: ibuprofen) as they cause harm to the fetus.
Risks to the pregnant woman and the child:
- Pregnant women with sickle cell anemia are exposed to more chances of having premature or low-birth-weight babies, but the majority have healthy babies if they are well monitored and controlled before and during pregnancy.
- Sickle cells can cause frequent pain attacks during pregnancy, especially when care is not taken about the causes that lead to the attacks (such as: cold weather, vigorous physical activity or dehydration).
- It is possible to experience eclampsia or cramps in advanced stages of pregnancy (a state of high blood pressure and the presence of protein in the urine).
- In the last months of pregnancy, exposure to chest syndrome increases, as she should go to the nearest hospital in the event of feeling shortness of breath or chest pain.
Medical care during pregnancy:
- Ensure the validity of annual vaccinations (e.g.: hepatitis B, influenza, pneumonia).
- Make sure to visit the doctor on a weekly basis after the 24th week of pregnancy until the time of delivery; Where he will undergo a routine examination in addition to other examinations (such as: blood pressure examination, urine test, and an examination of the growth of the fetus).
- Blood transfusions are not usually given to patients with sickle cells, but if needed, this matter will be discussed.
Additional medical care:
Checking the risk of thrombosis (blood clots in legs or lungs) early in pregnancy, if there is any risk factor (e.g.: being overweight).
The stage of labor and delivery:
- Delivery must take place in the hospital; to reduce complications.
- Suitable blood transfusion bags are prepared in case they are needed.
- The fetal heartbeat will be closely monitored during labor.
- In the event of resorting to a caesarean section, the anesthesiologist must be seen before the date of delivery to discuss pain relief solutions.
- It is usually advised to transfuse blood before a caesarean section, especially when hemoglobin level is low.
Breastfeeding:
Breastfeeding poses no danger to the mother or the child, but support and encouragement will be given to breast-feeding.
Contraceptive:
Women with sickle cell anemia are recommended a certain type of contraceptive, which is:
- Progesterone tablets, Depo-Provera injections, subcutaneous implants, hormonal IUDs, and condoms.
- The estrogen contraceptive and the copper IUD can be used only if the above methods are not suitable.