1. Gynecology and Obstetrics Department, Adnan Menderes University, Aydın
Evaluation of two cases of sickle cell anemia and thalassaemia in pregnancy
Selda Demircan Sezer
Gynecology and Obstetrics Department,
Adnan Menderes University, Aydın

2. Case 1: G2P1, 33-year-old, 7 wks' gestation
Heterozygote for beta-thalassemia + hemoglobin S
History: ES / 15 days interval until delivery
Vaso-occlusive crisis in present pregnancy
Exchange transfüsion (5 times) and 2-3 U ES given/1 month interval until delivery
Hb (hemoglobin): 6,8-8,7 g/dL

3. Case 1: Caesarean section (CS) because of previos CS history
Exchange transfusion made before CS
3440gr baby, 1st Apgar score 9, 5th Apgar score 10, male fetus delivered
Postpartum 2 U ES
No complication

4. Case 2: G2P1,37-year-old, 17 wks' gestation
Double heterozygote for beta-thalassemia and hemoglobin S
Obstetric History: No Exchange transfüsion and intrauterin fetal death at term, DIC
No vaso-occlusive in present pregnancy
Exchange transfüsion 7 times and 2-3 U ES /1 month interval until delivery

5. Case 2:
Hb: 6,2-8,4 g/dL
At 38th wk planned CS made becaause of previos intrauterin death
2 U exchange transfusion preoperative
3120gr, 1st Apgar score 6, 5th Apgar score 7, male fetus
Intrapartum 1 U ES
No complication

6. Pregnancy increases the incidence of sickle cell specific complications:
Anaemia
Vaso-occlusive crisis, abdominal, pulmonary (acute chest syndrome)
Placental thrombosis
Infections (urinary tract infection, pyelonephritis, pneumonia)
Toxemia

7. Pregnancy increases the incidence of sickle cell specific complications:
Maternal death
High risk of spontaneous abortion
Intra-uterine growth retardation
Intra-uterine fetal death
Preterm delivery
Perinatal mortality related to hypoxemia and placental thrombosis

8. Evaluation of sickle cell anemia
Specific management program
A close multidisciplinary approach for the duration of the pregnancy, the delivery and the postpartal period
In tertiary maternal health services level
Blood transfusion depends on teams
Restricted maternal, obstetrical and hematologic indications

9. Summary Fetal mortality and morbidity high
Intrauterine growth retardation
Fetal death being the most frequent fetal complications
The rates of prematurity and caesarean section
A multidisciplinary and specific approach
Manage efficiently pregnancy, delivery and postpartum