Sickle Cell Disease in Pregnancy: Active Nursing Management

Download Article

DOI: 10.21522/TIJNR.2015.03.02.Art009

Authors : Anisley Fabars Johnson


Sickle cell disease is considered as a major complication and risk factor for perinatal morbidity /mortality. Literature document that most pregnancies complicated by sickle cell are likely to result in live birth, but the consequences of influence of the disease for the pregnancy/newborn remains a significant concern for health care providers worldwide. According to the bibliography obstetrical-fetal risks are due to the metabolic demands, hypercoagulable state, and vascular stasis associated with pregnancy characterized normally for blood cells to be able to carry oxygen to the growing fetus. With sickle cell anemia, the abnormal red blood cells and anaemic characteristics of the disease physiopathology may result in lower amounts of oxygen going to the developing baby with negative outcome for the future newborn.

Research review studies agreed that access of the pregnant client to a multidisciplinary care team knowledgeable about sickle cell disease and high-risk obstetrics can significantly decrease feto-maternal morbidity and mortality. Example: decreases in spontaneous miscarriage, in perinatal death rates and lowered incidence of preterm labour. Active prenatal management include: education; genetic counselling and prenatal diagnosis for couples at risk; improving nutritional status; vaccination for disease prevention, and early detection of bacterial infection.

Objective of this study was to explore active nursing management of the pregnant women with sickle cell disease, including education, treatment and nursing intervention.

Method: use of English Literature review current through: Jun 2017, Data were searched using MEDLINE, EMBASE, PUBMED and COCHRANE Systematic Reviews.

Keywords: Sickle Cell Disease, complication, feto-maternal risk, active nursing management.


[1].     Eugene Oteng-Ntim, Daveena Meeks, Paul T Seed, Louise Webster, Jo Howard, Pat Doyle, and Lucy C Chappell. Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis. Blood, March 2015 DOI: 10.1182/blood-2014-11-607317

[2].     Goldsmith JC, Bonham VL, Joiner CH, et al. framing the research agenda for sickle cell trait: building on the current understanding of clinical events and their potential implications. Am J Hematol 2012; 87:340.

[3].     NHLBI. Evidence-Based Management of Sickle Cell Disease: Expert Panel Report, 2014. p.24. (Accessed on August 11, 2014).

[4].     Oteng-Ntim E, Meeks D, Seed PT, Webster L, Howard J, Doyle P, Chappell LC. Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis. Blood. 2015; 125(21):3316-25. [PubMed]

[5].     Oteng-Ntim E, Ayesha B, Knight M, Howard J. Pregnancy outcome in patients with sickle cell disease in the UK--a national cohort study comparing sickle cell anaemia (HbSS) with HbSC disease. Br J Haematol 2015; 169:129.

[6].     Pintova S, Cohen HW, Billet HH. Sickle cell trait: is there an increased VTE risk in pregnancy and the postpartum? PLoS One 2013; 8:e64141.

[7].     Royal College of Obstetricians and Gynaecologists Green-top. Guideline Management of sickle cell disease in pregnancy. RCOG. 2011; 61:1–20.

[8].     Souza J.P., Cecatti J.G., Fagundes A., Morais S.S., Villar J., Carroli G.A. Maternal near miss and maternal death in the World Health Organization's 2005 global survey on maternal and perinatal health. Bull World Health Org. 2010; 88:113–119. [PubMed].

Yawn BP, Buchanan GR, Afenyi-Annan AN, et al. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members. JAMA 2014; 312:1033.