摘要
Context: In pregnant women with sickle cell disease, the management with exchange transfusion could be useful in improving the prognosis of mother and child by reducing the level of hemoglobin S less than 40%. Objective: To analyze the maternal and perinatal outcome during the program of the exchange transfusion in pregnant women with sickle cell disease. Patients and Methods: We conducted a prospective study over a period of 18 months. Pregnant women with a major form of sickle cell disease were included. A manual blood exchange transfusion was performed monthly. We monitored the occurrence of maternal and perinatal morbidity during the follow-up. Results: A total of 42 pregnant women with sickle cell disease were monitored. The frequency of infectious episodes and vaso-occlusive crisis was significantly reduced, respectively from 47.6% and 83.3% before the beginning of the blood exchanges transfusion to 11.9% and 16.7% during blood exchanges transfusion program. All newborns were alive at birth with an Apgar score higher or equal to 7 at the 5<sup>th</sup> minute. The rate of admission of the newborns at neonatal intensive care unit was 9.3%. Maternal mortality was estimated at 7.1% and there was no early neonatal mortality. Conclusion: Prophylactic exchange transfusion reduces infections and the reoccurrence of vaso-occlusive crisis, which has an impact on perinatal prognosis.
Context: In pregnant women with sickle cell disease, the management with exchange transfusion could be useful in improving the prognosis of mother and child by reducing the level of hemoglobin S less than 40%. Objective: To analyze the maternal and perinatal outcome during the program of the exchange transfusion in pregnant women with sickle cell disease. Patients and Methods: We conducted a prospective study over a period of 18 months. Pregnant women with a major form of sickle cell disease were included. A manual blood exchange transfusion was performed monthly. We monitored the occurrence of maternal and perinatal morbidity during the follow-up. Results: A total of 42 pregnant women with sickle cell disease were monitored. The frequency of infectious episodes and vaso-occlusive crisis was significantly reduced, respectively from 47.6% and 83.3% before the beginning of the blood exchanges transfusion to 11.9% and 16.7% during blood exchanges transfusion program. All newborns were alive at birth with an Apgar score higher or equal to 7 at the 5<sup>th</sup> minute. The rate of admission of the newborns at neonatal intensive care unit was 9.3%. Maternal mortality was estimated at 7.1% and there was no early neonatal mortality. Conclusion: Prophylactic exchange transfusion reduces infections and the reoccurrence of vaso-occlusive crisis, which has an impact on perinatal prognosis.
作者
Hyacinthe Zamané
Dantola Paul Kain
Sibraogo Kiemtoré
Abdoul Azize Diallo
Jean Baptiste Valéa
Samba Diallo
Fabienne Sanou
Jean Lankoandé
Hyacinthe Zamané;Dantola Paul Kain;Sibraogo Kiemtoré;Abdoul Azize Diallo;Jean Baptiste Valéa;Samba Diallo;Fabienne Sanou;Jean Lankoandé(Department of Obstetrics and Gynecology, Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Ouagadougou, Burkina Faso;Unity of Training and Research in Health Sciences (UFR/SDS), University of Ouagadougou, Ouagadougou, Burkina Faso;National Center of Blood Transfusion, Ouagadougou, Burkina Faso;Department of Internal Medicine, Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Ouagadougou, Burkina Faso)