Management of sickle hemoglobinopathies in pregnant patients

During the past decade, pregnancy outcome has improved among patients with sickle hemoglobinopathies. The role of prophylactic exchange transfusion in this improvement is uncertain. This study reviews the experience in 64 pregnancies managed at the Medical University Hospital over a 7 year period. Prophylactic exchange transfusion was not associated with improved pregnancy outcome and was associated with significant antibody formation. Exchange transfusion may best be reserved as a treatment modality when infection, crisis, or symptomatic anemia occurs in patients with a sickle hemoglobinopathy.