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Pregnancy period

Preconception Care Of Sickle Cell Disease In Pregnancy

Preconception care of sickle cell disease in pregnancy is the management of sickle cell crisis and precautions taken to control complications and severity of sickle cell disease in pregnancy. Preconception care is the set of procedures taken to identify and maintain risks to maternal and fetal health during pregnancy. 

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Pregnancy in women with sickle cell disease is associated with adverse outcomes for both mother and child, but with care and medications administered rightly, mother and child are able to be monitored properly and kept safe from severe complications and situations.

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Pregnancy and conception should be embedded into routine care for women with sickle cell disease and the care should include discussion of reproductive options, partner screening, optimization of health prior to conception, preconception folic acid supplementation, and review of teratogenic medications. Folic acid supplementation in pregnant women with sickle cell disease should be five milligrams daily (5mg) this helps in the prevention of neural tube defect, and also compensate for the increased demand during pregnancy and should therefore be commenced conceptually.  

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Vitamin D deficiency is common in pregnant patients with sickle cell disease and regular monitoring and supplementation are recommended for patients. Pregnant patients with sickle cell disease are hyposplenism and are at major risk of infection, with microorganisms in particular from encapsulated bacteria such as Neisseria meningitides, Streptococcus pneumonia, and Hemophilus influenza. 

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Due to the increased risk of pneumonia and a view of their hyposplenism, they are to continue penicillin prophylaxis. Vaccination status should also be reviewed and updated as per a medical confirmed personnel recommendation, and the medication of the use of vaccines could also include annual influenza vaccination and pneumococcal vaccination if it has not been given in the previous five years.

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The standard analgesics to be used in preconception care of pregnant women with sickle cell disease are paracetamol and codeine-containing analgesics and can be offered during pregnancy as first-line agents. If not effective, non-steroidal anti-inflammatory drugs are NSAIDs. 

Content created and supplied by: Dr-Kikiope (via Opera News )

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