Management of sickle cell disease in pregnancy: A case series of 15 patients in a secondary maternity type 2B setting

Abstract

Background: Sickle cell disease (SCD) poses significant challenges during pregnancy due to increased risks of maternal and fetal complications. Effective management in resource-constrained settings, such as secondary maternity type 2B hospitals, requires tailored protocols to optimize outcomes. Objective: To describe the clinical management and outcomes of 15 pregnant women with SCD in a secondary maternity type 2B facility. Methods: A retrospective case series of 15 pregnant women with confirmed SCD (HbSS or HbSC) managed between January 2022 and December 2024 at a secondary maternity type 2B hospital. Data on demographics, clinical presentation, management strategies, and maternal-fetal outcomes were extracted from medical records. Results: The cohort had a mean age of 27.3 years (range: 20-35). Ten patients had HbSS, and five had HbSC. Common complications included vaso-occlusive crises (73.3%), anemia requiring transfusion (60%), and preeclampsia (26.7%). Management included multidisciplinary care, hydration, analgesia, prophylactic antibiotics, and selective blood transfusions. Cesarean delivery was performed in 46.7% of cases. Maternal mortality was 0%, with one preterm neonatal death (6.7%). Conclusion: Comprehensive management of SCD in pregnancy within a type 2B maternity setting is feasible with multidisciplinary care, leading to favorable maternal outcomes despite resource limitations. However, neonatal risks underscore the need for enhanced fetal monitoring.