Women With Homozygous Sickle Cell Disease

928 WordsMay 28, 20164 Pages
Case Study: A 25-year-old women with homozygous sickle cell disease presented to tertiary center at 32 weeks’ gestation with weakness, fever, and worsening anemia. Her obstetric history included previous pregnancy post two years complicated with mild preeclampsia resulting in cesarean delivery at term, but had no reports of sickle cell complications like painful crisis, splenic sequestration or blood transfusion. On arrival she reported left upper abdominal pain, temperature 38oC, heart rate 115bpm, blood pressure of 120/80. Her spleen was palpable 4cm below left costal margin with tenderness. Laboratory results indicated hemoglobin 2.4g/dl and hematocrit 7.8%. Fetal monitoring was performed for 60 minutes, baseline fetal heart rate was 150 bpm with absence of variability and accelerations. At beginning of record a prolonged deceleration lasting four minutes was noted. The volume of amniotic fluid was normal and the fetal biophysical profile was 6. Two packs of red blood cells were immediately transfused, resulting in progression of fetal heart rate and biophysical profile to normal. Twelve hours after transfusion patient’s hemoglobin was 4.3g/dl and two additional packs of red blood cells were transfused. Twenty-four hours later patient’s hemoglobin was 5.9g/dl, and after one more additional unit of packed red blood cells her level increased to 7.4g/dl. The patient was kept in hospital with ultrasound indicating normal fetal growth and antenatal fetal surveillance

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