My niece who has sickle cell disease wants to start a family. Is this a good idea? If yes, kindly advise us on the necessary precautions to take.
Godwin (by SMS)
Sickle cell disease is a blood disorder passed down from parent to child. People with sickle cell disease have abnormal hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen to the body. Normal red blood cells are smooth, round, and flexible. They look like the letter “O.” This helps them carry oxygen and move through the vessels easily.
The abnormal hemoglobin in sickle cell disease makes the red blood cells stiff and sticky. They form into the shape of a sickle, or the letter “C.” These sickle cells tend to clump together and can’t easily move through the blood vessels. The clumps block the flow of healthy, oxygen-carrying blood. This causes pain and damages tissues.
How sickle cell disease affects pregnancy depends on whether you have sickle cell disease or sickle cell trait. Some women with sickle cell disease have no change in their disease during pregnancy. In others, the disease may get worse. Painful events called sickle cell crises may still occur in pregnancy. These events may be treated with medicines that are safe to use during pregnancy. If you have kidney disease or heart failure before you get pregnant, it may get worse during pregnancy. Generally, women with sickle cell trait do not have problems from the disorder. But they may have a lot of urinary tract infections during pregnancy.
Pregnant women with sickle cell trait can also have a kind of anemia caused by not having enough iron in their blood. If you have this type of anemia, you may need to take iron supplements.
In pregnancy, it is important for blood cells to be able to carry oxygen. With sickle cell anemia, the abnormal red blood cells and anemia may result in lower amounts of oxygen going to your developing baby. This can slow down the baby’s growth. Early and regular prenatal care is important if you are pregnant and have sickle cell disease. Having prenatal visits more often allows your healthcare provider to keep a close watch on the disease and on the health of developing baby. Some women may need blood transfusions to replace the sickle cells with fresh blood. These may be done several times during the pregnancy. Blood transfusions can help the blood carry oxygen and lower the number of sickle cells.
If you get blood transfusions, you will be screened for antibodies that may have been transferred in the blood and that may affect your baby. The most common antibodies are to the blood factor Rh. Because sickle cell disease may affect your developing baby, your provider may start testing in the second trimester to check on the health and well-being of the baby.
During labor, the attending physician will provide IV (intravenous) fluids to help prevent dehydration. You may also get extra oxygen through a mask during labor. A fetal heart rate monitor is often used to watch for changes in your baby’s heart rate. It also watches for signs of fetal distress. Most women can deliver vaginally unless there are other complications.
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