Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Hemoglobinopathy is a diverse group of inherited single gene disorder of haemoglobin production and function; they are inherited as autosomal co‐dominant traits. Each year about 0.3 million infants are born with a major hemoglobinopathy. Sickle cell hemoglobinopathy is the most common hemolobinopathy encountered during pregnancy. (a) To find out the prevalence of sickling positive cases in pregnant women admitted to department of O and G, MKCG Medical College, Berhampur (b) To study the feto‐maternal complications and outcome in sickling positive pregnant women. The study was a prospective observational study conducted in the department of O and G of MKCG Medical College, Berhampur, Odisha; India, leading medical college of southern Odisha from December 2016 to October 2018. Those pregnant women having sickling positive were subjected for detailed history taking followed by clinical examination. Routine examination covering hemoglobin, TLC, CPS, VDRL, HIV, HbsAg, TFT, urine (R and M) and obstetric ultrasound were done for all selected cases followed by electrophoresis and HPLC. They were promptly treated for any sickle cell crisis or other complications. Information on mode of delivery, indications of caesarean section, maternal and fetal complications was noted. Fetal outcome like live born or still born, birth weight, babies requiring neonatal intensive care monitoring were also noted. Incidence of the diseases was 0.54 % including 23 cases (0.14%) of sickle cell disease (SS or homozygous) and 61 cases (0.37%) of sickle cell trait (AS or heterozygous). When the normal hemoglobin concentration was taken as 11 g%, 23 cases (100%) of SS women, 59 cases (96.7%) of AS women and 78 cases (92.8%) of control women were anemic. In SS group 9 cases (39.1%) of women were severely anemic whereas in AS and control group 5 cases (8.1%) and 3 cases (3.5%) women were severely anemic. Out of 23 SS women, 8 cases (34.8%) were having UTI whereas 9 cases (14.7%) and 11 cases (13.1%) of AS and control group have UTI respectively. Women who had suffered from painful crisis were 7 cases (30.4%) of SS, 3 cases (4.9%) of AS group respectively. Painful crisis of SS group were more compared to control group which is statistically significant. Out of all, 9 cases (39.1%), 7 cases (11.5%) and 4 cases (4.8%) of SS, AS and control group women presented with pregnancy induced hypertension(PIH) and incidence of PIH is high in case of SS women as compared to control group. Post‐partum hemorrhage(PPH) was seen in 8 cases (34.8%), 2 cases (3.2%) and 3 cases (3.5%) of SS, AS and control group respectively and incidence of PPH is more in SS group as compared to control group. Maternal mortality was seen in 3 cases (13.0%) of SS women and 2 cases (3.2%) of AS women i.e incidence of maternal death is high among SS group as compared to control group. PIH was indication in 2 cases (18.1%), 1 case (8.3%) and 2 cases (10.0%) of SS, AS and control group respectively. Previous C.S was indication in 4 cases (36.3%), 5 cases (41.6%) and 8 cases (40.0%) of SS, AS and control group respectively. Hypoxic ischemic encephalopathy (HIE) was seen in 2 babies (3.2%), 3 babies (3.5%) of AS and control group respectively. Anemia in newborn was seen in 1 case (4.3%), 1 case (1.6%) and 1 case (1.2%) of babies of SS, AS and control group respectively. The total perinatal death included 3 cases (13.0%), 8 cases (13.1%) and 8 cases (9.5%) of SS, AS and control group respectively. Premarital counseling and testing for the sickle cell gene with close antenatal check‐up, identification of antenatal complications and good intranatal management in a well‐equipped hospital will help in achieving the improvement of fetal outcomes and also prevent the maternal complications.
How to cite this article:
Susanta Kumar Behera, Bipin Bihari Malik, Jyoti Ranjan Behera and Sujata Rout. Fetomaternal Outcome in Patients with Sickle Cell Disease in Southern Odisha, India.
DOI: https://doi.org/10.36478/10.59218/makrjms.2023.9.48.53
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2023.9.48.53