Pregnancy-Related Thromboembolismin Sickle Cell Disease

Salma M. AlDallal
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Abstract

Haematological disorders are predominant in the tropical and subtropical countries where major problems of sickle-cell disease (SCD) and thalassaemias are often recorded. However, reports of these conditions have increased in the Western hemisphere more recently. Genetic counselling, early detection of the disease condition, and determining an appropriate treatment regimen remains the solution. Most molecular types of SCD have been determined and the pathological impact of individual types along with the degree of severity is known to clinical investigators and physicians. There is, however, a significant need for a proper counselling system for the clinical diagnosis in most countries. Lack of funding, trained personnel, relevant physicians, instruments, and laboratories are the challenges to overcome. Pregnancy-associated SCD and thromboembolism require special mention due to their mortality rate, complexity of treatment, and care necessities. This review considers some of the most important aspects of pregnancy-associated SCD and thromboembolism, shedding light on the present understanding of the disease condition, pathology, clinical issues, the association with venous thromboembolism, recent treatment measures, and clinical and social management of pregnant women and fetuses for patients with SCD. Integrated social and clinical care along with extensive timely medical and clinical counselling for patients can improve the present situation which is growing in different countries. To save future generations and pregnant mothers from the haematological disorders that could be either prevented or treated, essential genetic screening or counselling should be made a priority by governments. In addition, social education and campaigns related to the disease condition can help to improve the situation.
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妊娠相关血栓栓塞性镰状细胞病
血液病在热带和亚热带国家占主导地位,那里经常记录镰状细胞病(SCD)和地中海贫血等主要问题。然而,最近在西半球有关这些情况的报告有所增加。遗传咨询、早期发现疾病状况和确定适当的治疗方案仍然是解决办法。大多数SCD的分子类型已经确定,临床研究人员和医生都知道个体类型的病理影响以及严重程度。然而,在大多数国家,迫切需要一个适当的临床诊断咨询系统。缺乏资金、训练有素的人员、相关医生、仪器和实验室是需要克服的挑战。由于其死亡率、治疗复杂性和护理必要性,妊娠相关性SCD和血栓栓塞需要特别提及。这篇综述考虑了妊娠相关性SCD和血栓栓塞的一些最重要的方面,揭示了目前对SCD患者的疾病状况、病理、临床问题、与静脉血栓栓塞的关系、最近的治疗措施以及孕妇和胎儿的临床和社会管理。综合社会和临床护理以及对患者的广泛及时的医疗和临床咨询可以改善目前在不同国家日益严重的状况。为了使后代和孕妇免受可以预防或治疗的血液病之患,各国政府应将必要的遗传筛查或咨询作为优先事项。此外,与疾病状况有关的社会教育和运动可以帮助改善这种状况。
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