scholarly journals Does first‐trimester serum pregnancy‐associated plasma protein A differ in pregnant women with sickle cell disease?

2019 ◽  
Vol 39 (10) ◽  
pp. 921-924
Author(s):  
Gergana Peeva ◽  
Laura Oakley ◽  
Inez Rège ◽  
Kypros Nicolaides ◽  
Eugene Oteng‐Ntim
Keyword(s):  
Sickle Cell Disease ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Plasma Protein ◽  
Protein A ◽  
First Trimester ◽  
Cell Disease

O945 Maternal morbidity in pregnant women with sickle cell disease

2009 ◽  
Vol 107 ◽  
pp. S362-S362
Author(s):  
K. Tosta ◽  
R. Nomura ◽  
A. Igai ◽  
G. Fonseca ◽  
S. Gualandro ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Maternal Morbidity ◽  
Cell Disease

scholarly journals Hydroxycarbamide (HU), Sickle Cell Disease and Pregnancy, a Multicentric Retrospective Study

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1309-1309 ◽  
Author(s):  
Laure Joseph ◽  
Anoosha Habibi ◽  
Giovanna Cannas ◽  
Stephanie Ngo ◽  
Sylvain Le Jeune ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Unplanned Pregnancy ◽  
Significant Risk ◽  
First Trimester ◽  
European Medicines Agency ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Teratogenic Effects ◽  
Childbearing Potential

Abstract HU is a myelosuppressive drug marketed since 1968 for the treatment of hematological malignancies, and authorized since 2007 in Europe as an orphan medicinal product for the prevention of recurrent vaso-occlusive crises and acute chest syndrome in adults and children older than 2 years with sickle cell disease (SCD). ESCORT-HU (European Sickle Cell Disease Cohort - Hydroxyurea) is a multicenter prospective non interventional study implemented in Europe to collect more information about the safety profile and morbidity-mortality in SCD patients treated with HU. The study responds to an EMA (European Medicines Agency) request and has been approved by the Ethical Committee of Necker Enfants Malades Hospital (Paris, France). Some teratogenic effects of HU have been observed in fetuses of treated pregnant rodents (Woo, Katayama et al. 2004;Yan and Hales 2005 ;Chahoud and Paumgartten 2009). Hydroxyurea has been demonstrated to be embryotoxic at doses over 150 mg/kg/day in rats and in monkeys (Liebelt, Balk et al. 2007). Embryotoxicity was characterized by decreased fetal viability, reduced live litter sizes, and developmental delays. On the other hand, a recent study on pregnant mice showed no evidence of teratogenic effects with intraperitoneal injection of HU (25mg/kg) on gestation day (GD) 7.5 (Zhen Guan et al. 2015). Due to the potential teratogenic effects in animal models, although no malformations have been reported in humans to date (Khushnooma et al. 2010,), the use of HU is not recommended during pregnancy. The pregnancy in SCD can be associated with adverse maternal and perinatal outcomes. The rate of spontaneous abortion is more than 30% in our cohort at Necker Hospital and in literature (Regina Amelia Lopes Pessoa Aguiar et al. 2014, Sophie Lanzkron et al. 2012). Women of childbearing potential receiving HU should be advised to use contraception to avoid becoming pregnant. If there is a desire for pregnancy, HU must be stopped 3 to 6 months before conception and switched for chronic transfusion until the delivery or the end of breast feeding with a significant risk of allo-immunization (Ngo et al. 2010, Howard et al. 1995). In our experience, we have noticed that as pregnancies started frequently under HU, it is necessary to improve our knowledge about the use of HU during pre-conception or organogenesis in SCD patients and eventually develop new therapeutic strategies. From June 2008 to July 2016, 1050 patients (496 children and 554 adults) were enrolled in ESCORT-HU from 3 European countries, Greece (11.7%), Germany (13.4%), and France (74.9%). Among the 315 women with childbearing potential (aged more than 15 to 49 years), 28 pregnancies in 27 women treated with HU have been reported despite the information to stop HU before conception (Table 1). Clinical data regarding the newborn are reported for 7 pregnancies with HU exposure and no malformations were observed. In women treated with HU: • HU was stopped in 15 (15 pregnancies) women during the first trimester of pregnancy (9 before 6 WA). The outcome of these pregnancies were 5 normal births, 5 premature births, 3 ongoing pregnancies, 1 voluntary abortion, 1 unknown • HU was used during the whole pregnancy in 1 woman (issue normal birth), • Information on treatment discontinuation was not reported in the database for 8 women. In our study, a large majority of pregnancies (89%) occurred while HU was not stopped which correlates with the high rates of unplanned pregnancy in SCD women (Smith-Withley et al 2014, Eissa et al 2014). The use of HU during organogenesis or pre-conception period in our cohort seems to have no impact on the materno-fetal and new-born morbi-mortality which is consistent with literature data (Khushnooma et al. 2010). Even if women of childbearing potential receiving HU should be advised to avoid becoming pregnant, in this series nested in the ESCORT HU cohort pregnancies occurred safely despite HU. These results are important because they could help to limit the indications and duration of transfusion and therefore the risk of allo-immunization and delayed hemolytic transfusion reaction in this at-risk population. Nevertheless this preliminary work needs to be confirmed by a comprehensive collection which could help us to evaluate the risk-benefit ratio, of HU versus blood transfusion during pregnancy in SCD women. Disclosures Ribeil: Bluebirdbio: Consultancy; Addmedica: Research Funding.

P357 Perinatal and maternal outcomes in pregnant women with sickle cell disease and sickle cell trait

2009 ◽  
Vol 107 ◽  
pp. S516-S516
Author(s):  
K. Tosta ◽  
R. Nomura ◽  
A. Igai ◽  
G. Fonseca ◽  
S. Gualandro ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Maternal Outcomes ◽  
Cell Disease

scholarly journals Iron stores in pregnant women with sickle cell disease: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e026497 ◽  
Author(s):  
Desmond Aroke ◽  
Benjamin Momo Kadia ◽  
Tsi Njim
Keyword(s):  
Systematic Review ◽  
Sickle Cell Disease ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Iron Deficiency Anaemia ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Cell Disease ◽  
Deficiency Anaemia

IntroductionSickle cell disease (SCD) is the most common inherited disease worldwide. The greatest disease burden is seen in sub-Saharan Africa. Early diagnosis and improved care of people living with SCD have led to an increase in the number of women with SCD reaching the reproductive age. Iron deficiency anaemia remains the most common cause of anaemia in pregnancy, affecting 51%–63% of pregnancies in Africa. However, the unavailability of guidelines on supplementation of iron in this pregnant subpopulation often leaves clinicians in a fix. We propose to conduct the first systematic review and possibly a meta-analysis on the prevalence, associated factors and maternal/fetal outcomes of iron deficiency anaemia among pregnant women with SCD.Methods and analysisWe will search the following electronic databases for studies on the iron status of pregnant women with SCD: PubMed, MEDLINE, EMBASE, Google Scholar, African Journals Online, African Index Medicus, Popline and the Cochrane Library. After the selection of eligible studies from the search output, review of full text, data extraction and data synthesis will be performed. Studies obtained from the review shall be evaluated for quality, risk of bias and heterogeneity. Appropriate statistical methods shall be used to pool prevalence estimates for matching studies globally and in subpopulations. This protocol has been reported as per the 2015 guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.Ethics and disseminationThere is no requirement for ethical approval as the proposed study will use published data. The findings of this study will be published in a peer-reviewed journal and will be presented at conferences.Trial registration numberCRD42018109803.

Transfusion practices in the care of pregnant women with sickle cell disease in Ouagadougou

2019 ◽  
Vol 147 (3) ◽  
pp. 363-367
Author(s):  
Hyacinthe Zamané ◽  
Fabienne Sanou ◽  
Sibraogo Kiemtoré ◽  
Dantola Paul Kain ◽  
Arnaud Kiswendsida Sawadogo ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Cell Disease

Psychological help for pregnant women with sickle cell disease

2009 ◽  
Vol 19 (7) ◽  
pp. 26-29 ◽  
Author(s):  
Veronica Thomas ◽  
Heather Rawle ◽  
Jo Howard ◽  
Mina Abedian ◽  
Neill Westerdale ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Psychological Help ◽  
Cell Disease

Prevalence of Sickle Cell Disease in Pregnant Women and Neonates in Africa

2018 ◽  
Author(s):  
Dr.Callixte Yadufashije ◽  
George Bahati Sangano ◽  
Rebero Samuel
Keyword(s):  
Sickle Cell Disease ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Cell Disease

Physiologic observations of pregnant women undergoing prophylactic erythrocytapheresis for sickle cell disease

Transfusion ◽  
1991 ◽  
Vol 31 (1) ◽  
pp. 59-62 ◽  
Author(s):  
W Lee ◽  
J Werch ◽  
R Rokey ◽  
J Pivarnik ◽  
J Miller
Keyword(s):  
Sickle Cell Disease ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Cell Disease

Folic Acid Supplementation and Twin Pregnancy in Patients with Sickle Cell Disease.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3744-3744
Author(s):  
Samir K. Ballas ◽  
Jason Baxter ◽  
Gaye Riddick
Keyword(s):  
Folic Acid ◽  
Sickle Cell Disease ◽  
Pregnant Women ◽  
Sickle Cell ◽  
Folic Acid Supplementation ◽  
Multiple Births ◽  
Cell Disease ◽  
Folate Supplementation ◽  
Acid Supplementation ◽  
Twin Pregnancies

Abstract Patients with sickle cell disease (SCD) usually take 1mg of folic acid daily. The rationale for this approach is to maintain effective erythropoiesis with a stable hemoglobin level. Other potential advantages of folate therapy in patients with SCD include the prevention of hyperhomocysteinemia that may predispose to thrombotic events, which, in turn, may lead to painful episodes. Moreover, folate supplementation during pregnancy is known to prevent neural tube defects in infants. The major disadvantage of folate supplementation in patients with SCD is that it may mask vitamin B12 deficiency. Another controversial effect of folic acid supplementation pertains to its potential effect on the number of twins coming to term. We reviewed our database on patients with SCD to determine the effect, if any, of folic acid supplementation on twin pregnancies. The data were collected prospectively since 1981. All patients routinely took 1.0 mg of folic acid orally on a daily basis. Random testing of the level of folic acid in the steady state in women with SCD including those who became pregnant showed increased levels to > 20ng/ml (Normal range: 3.0–18.0 ng/ml) in most patients. Pregnant patients also took additional perinatal vitamins that also contained folic acid. We selected those pregnant patients in whom the outcome of pregnancy was either a liveborn or stillborn at or after 20 weeks’ gestation. We found that 46 patients with SCD became pregnant 60 times between 1981 and 2002 and who met the defined criteria mentioned above. The average maternal age at delivery was 26 years. Fifty-six pregnancies (93%) ended in liveborn and the remaining four (7%) in intrauterine fetal death. Five pregnancies (8.3%) resulted in the delivery of twins. This is a significantly higher rate of multiple births compared to other pregnant women. The reported rate of multiple births is between 0.34 and 1.1% both in Black and Caucasian women respectively. All twin births were dizygotic in nature. Patients with SCD take higher amounts of folic acid on a regular basis for a longer period of time before and after pregnancy than other pregnant women. This may explain why twin pregnancies are higher in these patients. The reason why folate therapy is associated with twinning is unknown at the present. Further studies may clarify the pathogenetic pathway of this phenomenon.

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