Pregnancy and Sickle Cell

Women with sickle cell disease (SCD) can have a relatively healthy pregnancy if…

They avoid all medications during pregnancy
They are automatically scheduled for a C-section
They have a coordinated, experienced team providing compassionate, high-quality care
They do not receive any blood transfusions

Which of the following is a common pregnancy complication that is especially important to monitor in women with SCD?

Appendicitis
Preeclampsia (high blood pressure and kidney involvement)
Asthma
Gallstones

Which symptoms can be warning signs of preeclampsia in pregnancy? (Choose ALL that apply)

Sudden swelling of the face and hands
Severe, sudden headache
Sudden unexplained weight gain
Mild thirst after exercise

In women with SCD, hospitalizations for acute pain and acute chest syndrome tend to increase most noticeably during which part of pregnancy?

Only in the first trimester
Only in the second trimester
Mostly toward the end of the first trimester and especially in the third trimester
Only after delivery

Which of the following BEST describes the current American Society of Hematology (ASH) guidance on routine prophylactic red cell transfusions for all pregnant women with SCD?

Strongly recommended for every pregnant woman with SCD
Not recommended; there is insufficient evidence to support routine prophylactic transfusions for everyone
Absolutely forbidden in pregnancy
Only allowed during labor

What is the main risk of frequent red cell transfusions in women with SCD during pregnancy?

Mild dehydration
Developing alloantibodies that make future transfusions more difficult and risky
Increased appetite
Lower risk of blood clots

Which combination represents a strong multidisciplinary care team for a pregnant woman with sickle cell disease?

Sickle cell expert, high-risk OBGYN / maternal–fetal medicine specialist, neonatologist/pediatrician, anesthesiologist/critical care specialist, and care coordinator (social worker/community health worker)
Dentist, dermatologist, and social media manager
Only a primary care doctor
Pharmacist and physical therapist

Hydroxyurea is automatically safe and recommended to continue at the same dose throughout pregnancy and breastfeeding for all women with SCD.

True
False

Which of the following are important pieces of personal medical information a woman with SCD should know and share with her team before or early in pregnancy? (Choose ALL that apply)

Her baseline blood pressure
Whether she has protein in her urine (early kidney damage)
History of blood clots or AVN of the hips
Any prior problems with blood transfusions or antibodies

Which of the following are key risks to watch for in the postpartum period (up to 6–12 months after delivery) for women with SCD?

Postpartum depression
Blood clots (DVT or pulmonary embolism)
Ongoing or increased pain and acute chest syndrome
All of the above

Quiz Summary

Information

Results

Results

Categories

1. Question

2. Question

3. Question

4. Question

5. Question

6. Question

7. Question

8. Question

9. Question

10. Question