Role of prophylactic and therapeutic red blood cell exchange in pregnancy with sickle cell disease: Maternal and perinatal outcomes

Background and Aim The incidence of fetomaternal complications during pregnancy is high for women with sickle cell disease (SCD), which is the most common hematologic genetic disorder worldwide. Prophylactic red blood cell exchange (pRBCX) has been shown to be efficient, safe, and feasible for preve...

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Published in:Journal of clinical apheresis 2021-06, Vol.36 (3), p.283-290
Main Authors: Yılmaz Baran, Şafak, Kozanoğlu, İlknur, Korur, Aslı, Doğan Durdağ, Gülşen, Kalaycı, Hakan, Alemdaroğlu, Songül, Asma, Süheyl, Kılıçdağ, Esra Bulgan, Boğa, Can
Format: Article
Language:English
Subjects:
Erythrocytes
Pregnancy
red cell exchange
Sickle cell disease
vaso‐occlusive crises
Womens health
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Summary:Background and Aim The incidence of fetomaternal complications during pregnancy is high for women with sickle cell disease (SCD), which is the most common hematologic genetic disorder worldwide. Prophylactic red blood cell exchange (pRBCX) has been shown to be efficient, safe, and feasible for preventing complications. The aim of this study was to observe maternal, perinatal, and neonatal outcomes of pregnancies in which pRBCX was. Method This was a single‐center, retrospective, cross‐sectional study, which recruited 46 consecutive adult pregnant women with SCD between January 2012 and June 2019. Obstetric features, SCD‐related complications, and fetomaternal outcomes were compared between the 27 patients who received prophylactic exchange and the 19 who did not (therapeutic exchange was performed in 7 and was not performed in 12 cases). Results Painful crises, preeclampsia, and preterm birth rates were significantly higher in the group that did not receive prophylactic exchange (control group; P = .001, P = .024, and P = .027, respectively). There was one maternal mortality in the control group (P = .41). Incidence of adverse fetal or maternal complications was significantly higher in the control group (P = .044 and P = .007, respectively). Conclusions Our center's experience over a 7.5‐year period, as described above, demonstrates that pRBCX in SCD affects the course of pregnancy positively by ameliorating negative fetomaternal outcomes.
ISSN:0733-2459
1098-1101
DOI:10.1002/jca.21819