MATERNAL SICKLE CELL TRAIT AND FETAL HYPOXIA

ABSTRACT

Patients with sickle cell trait (SCT) usually run a benign course. But they may develop vaso-occlusive crisis, which may lead to hypoxia. During these episodes, pregnant women with SCT may effect the developing fetus. This report describes an interesting finding of subtle degree of fetal hypoxia associated with maternal SCT. Twenty mothers with SCT were compared with 20 controls for the amount of circulating nucleated red blood cells (NRBC) and marker of fetal hypoxia at birth. Elevated number of circulating NRBC were noted in the cord blood of neonates born to mother with SCT as compared with controls, suggesting evidence of intrauterine fetal hypoxia. A larger prospective study is needed to elaborate further on this association.

Fetal hypoxia - sickle cell trait - nucleated red blood cell (NRBC) count

REFERENCES

• 1 Lane P A. Sickle cell disease.  Pediatr Clin North Am . 1996;  43 639-664
• 2 Charache S, Scott J, Niebyl J, Bonds D. Management of sickle cell disease in pregnant patients.  Obstet Gynecol . 1980;  55 407-410
• 3 Tuck S M, Studd J WW, White J M. Pregnancy in sickle cell disease in the UK.  Br J Obstet Gynecol . 1983;  90 112-117
• 4 Dare F O, Makinde O O, Faasuba O B. The obstetric performance of sickle cell disease patients and homozygous hemoglobin C patients in Ile-Ife, Nigeria.  Int J Gynecol Obstet . 1992;  37 163-168
• 5 El-Shafei A M, Dhaliwal J K, Sandhu A K. Pregnancy in sickle cell disease in Bahrain.  Br J Obstet Gynaecol . 1992;  99 101-104
• 6 Poddar D, Maude G H, Plant M J, Scorer H, Serjeant G R. Pregnancy in Jamaican women with homozygous sickle cell disease: fetal and maternal outcome.  Br J Obstet Gynaecol . 1986;  93 727-732
• 7 Powars D R, Sandhu M, Niland-Weiss J, Johnson C, Bruce S, Manning P R. Pregnancy in sickle cell disease.  Obstet Gynecol . 1986;  67 217-228
• 8 Seoud M AF, Cantwell C, Nobles G, Levy D L. Outcomes of pregnancies complicated by sickle cell and sickle-C hemoglobinopathies.  Am J Perinatol . 1994;  11 187-191
• 9 Anyaegbunam A, Mikhail M, Axioitis C, Morel M I, Merkatz I R. Placental histology and placental/fetal weight ratios in pregnant women with sickle cell disease: relationship to pregnancy outcome.  J Assoc Acad Minor Phys . 1994;  5 123-125
• 10 Decastel M, Leborgne-Samuel Y, Alexandre L, Merault G, Berchel C. Morphological features of the human umbilical vein in normal, sickle cell trait, and sickle cell disease pregnancies.  Hum Pathol . 1999;  30 13-20
• 11 Phelan J P, Ahn M O, Korst L M, Martin G I. Nucleated red blood cells: a marker for fetal asphyxia.  Am J Obstet Gynecol . 1995;  173 1380-1384
• 12 Korst L M, Phelan J P, Ahn M O, Martin G I. Nucleated red blood cells: an update on the marker for fetal asphyxia.  Am J Obstet Gynecol . 1996;  175 843-846
• 13 Philip A G, Tito A M. Increased nucleated red blood cell counts in small for gestational age infants with very low birth weight.  Am J Dis Child . 1989;  143 164-169
• 14 Green D W, Hendon B, Mimouni F B. Nucleated erythrocytes and intraventricular hemorrhage in preterm neonates.  Pediatrics . 1995;  96 475-478
• 15 Kramer M S, Oliver-Mclean F H, Willis D M, Usher R H. Impact of intrauterine growth retardation and body proportionality on fetal and neonatal outcome.  Pediatrics . 1990;  86 707-713
• 16 Kurlat I, Sola A. Neonatal polycythemia in appropriately grown infants of hypertensive mothers.  Acta Paediatr . 1992;  81 662-664
• 17 Hanlon-Lundberg K M, Kirby R S, Gandhi S, Broekhuizen F FE. Nucleated red blood cells in the cord blood of singleton term neonates.  Am J Obstet Gynecol . 1997;  176 1149-1156
• 18 Hann I M, Gibson B ES, Letsky-EA. Fetal and Neonatal Haematology.  1st ed. London: Bailliere Tindall 1991: 837
• 19 Miller D R. Blood Diseases of Infancy and Childhood.  7th ed. Philadelphia: Mosby-Year Book, Inc 1995: 836
• 20 Lanzkowsky P. Manual of Pediatric Hematology & Oncology.  1st ed. London: Churchill Livingstone, 1989: 7
• 21 Riyami A. Prevalence of hemoglobinopathies in Oman. Proceedings from the First International Conference of Hematology and Oncology, February 1997, Oman; 24-26