镰状细胞血红蛋白病包括一系列遗传的定性和定量血红蛋白疾病。这组疾病包括镰状细胞β地中海贫血,镰状细胞特征,镰状细胞病(SCD)。全球范围内,SCD是最常见的疾病。甚至流行病学数据也表明大多数疾病,以及特质,集中在撒哈拉以南非洲,东北非洲,中东,和印度。妊娠的生理变化易导致血管闭塞危象等灾难性事件的风险增加,血栓栓塞事件,以及它们相关的后遗症,最终导致绒毛梗塞,坏死,和纤维化导致子宫胎盘循环受损。相反,母亲可能会出现妊娠期高血压的症状加剧,胎盘早剥,早产,静脉血栓栓塞.虽然这种疾病是可以控制的,它有可能在国家一级对孕产妇和儿童健康产生不利影响。怀孕状态下影响母亲和胎儿的严重并发症的机会吸引了卫生服务机构对重新定义和研究这种疾病及其管理的适当关注。关于以下情况的文献综述主张在概念前护理的标题下观察一般治疗,加强产前保健,严格的产内护理,和合规的产后护理。先入为主,夫妇的遗传筛查,对这种疾病的不良影响进行教育,作为管理的第一线。较新的设施,如植入前遗传诊断和天体刺甚至可以允许早期诊断,并帮助那些不希望通过选择性转移未受影响的胚胎来终止妊娠的患者。这可以与对使用疫苗预防可预防疾病的夫妇的心理社会方面和社会经济地位的广泛评估相结合。加强产前护理与对每位登记的产前患者进行常规血液调查有关,这些患者对引发危机的条件有足够的认识。所有患者都应使用适当剂量的阿司匹林进行预防性治疗,铁,叶酸,和多种维生素。超声检查可用于监测前置胎盘,早剥,或早产。在怀孕后期,建议对脐动脉血流进行生物物理分析和评估.产内护理涉及对所有镰状细胞患病的母亲进行严格的机构分娩,并偏爱阴道分娩。产后护理需要精确评估分娩期间的失血量,以便在需要时立即开始输血治疗。纯母乳喂养,早期启动它的重要性,必须强调。必须尽快筛查新生儿的血红蛋白病。通过这次审查,作者试图了解SCD患者怀孕期间可能面临的并发症,其预防,以及根据各种新指南和现有研究进行的治疗。
Sickle cell hemoglobinopathies encompass a range of qualitative and quantitative hemoglobin disorders that are inherited genetically. This group of disorders includes sickle cell beta thalassemia, sickle cell trait, and sickle cell disease (SCD). Globally, SCD is the most common disorder. Even epidemiological data suggests the majority of diseases, as well as traits, are concentrated in Sub-Saharan Africa, North-East Africa, the Middle East, and India. The physiological changes in pregnancy predispose to an increased risk of catastrophic events like a vaso-occlusive crisis, thromboembolic events, and their related sequelae, leading eventually to villous infarction, necrosis, and fibrosis leading to compromising uteroplacental circulation. Conversely, the mother may exhibit exacerbated symptoms of gestational hypertension, placental abruption, preterm labor, and venous thromboembolism. Although this disease is manageable, it has the potential to adversely impact maternal and child health on a national level. The chances of severe complications in the pregnant state affecting both mother and fetus attract due attention of health services towards redefining and researching this disease and its management frequently. The literature
review on the following situation advocates the general treatment to be observed under the headings of preconceptual care, strengthened antenatal care, strict intranatal care, and compliant post-natal care. Preconceptually, genetic screening of couples, with education on the adverse effects of the disease, comes as the first line of management. Newer facilities like preimplantation genetic diagnosis and celocentesis may even allow for early diagnosis as well as help patients who do not wish to terminate the pregnancy by selective transfer of unaffected embryos. This may be combined with an extensive evaluation of the psychosocial aspect and socioeconomic status of couples who administer vaccines as prophylaxis for preventable diseases. Strengthening antenatal care is associated with routine blood investigations for every registered antenatal patient with adequate awareness about the conditions that precipitate the crisis. All patients should be prophylactically treated with appropriate doses of aspirin, iron, folic acid, and multivitamins. Radiological examinations by ultrasonography may be used to monitor placenta previa, abruption, or preterm labor. Later in pregnancy, it should be recommended to perform biophysical profiling and assessment of umbilical artery flow. Intranatal care deals with strict-term institutional delivery of all sickle cell-diseased mothers with a preference for vaginal delivery. Post-natal care requires a precise assessment of blood loss during labor to initiate transfusion therapy as soon as needed. Exclusive breastfeeding, with the importance of early initiation of it, must be emphasized. Screening of neonates as quickly as possible must be done for hemoglobinopathies. Through this
review, authors are trying to make aware of the complications that can be faced during pregnancy in SCD patients, its prevention, and its treatment according to various new guidelines and research available.