Pregnancy Outcomes of Mothers with Sickle Cell Disease: A Retrospective Review of Patients Seeking Delivery Services in a Regional Referral Hospital, Western Kenya

Khadija Hussein; Stephen Gwer; Willis Ochieng; Steven O. Tolo; Valentine lulana Munialo; Dickson Ngala

doi:10.37284/eajhs.8.1.2813

Khadija Hussein Jaramogi Oginga Odinga Teaching and Referral Hospital
Stephen Gwer Jaramogi Oginga Odinga Teaching and Referral Hospital
Willis Ochieng Jaramogi Oginga Odinga Teaching and Referral Hospital
Steven O. Tolo Jaramogi Oginga Odinga Teaching and Referral Hospital
Valentine lulana Munialo Jaramogi Oginga Odinga Teaching and Referral Hospital
Dickson Ngala Jaramogi Oginga Odinga Teaching and Referral Hospital

DOI: https://doi.org/10.37284/eajhs.8.1.2813

Keywords: Sickle Cell Disease, Feto-Maternal Outcomes.

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Abstract

Background: Western Kenya has a high burden of sickle cell disease (SCD) with 4.5% of children born with sickle cell disease. We aimed to describe the demographic characteristics and pregnancy outcomes of women with SCD at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). Methods: The hospital records department retrieved all files they could identify of women who were known to have SCD and had delivered at the hospital between October 2017 and December 2022. Data was analyzed using STATA version 16.0. Results: Thirty files were retrieved representing 30 women who delivered in the hospital. The mean age was 26 (18 to 36) years. Most 14 (46.7%) had a term delivery. The maternal mean haemoglobin level was 8.72g/dl (range 5.6-13.5). Twelve (40%) had moderate hemoglobin concentration (8-10g/dl) and only 3 (10%) had severe anemia with HB below 6.5g/dl. A majority (76. %) had normal vaginal delivery. The Caesarean section rate was 23%. There was no maternal mortality; one pregnancy was a multiple birth resulting in 31 babies. Nearly all (93%) of the babies had an APGAR score of more than 7 at five minutes, 5 (16.67%) required NBU admission for various reasons, while one (3.33%) of the babies died within 24 hours of birth. Three of the women used Hydroxyurea at some point in their pregnancies and all had morphologically normal babies. Discussion: Our study findings are comparable with other case series; no maternal death was documented, however, we noted fetal outcomes which are comparable to the regional indices. Conclusion: Though pregnancy in SCD is fraught with adverse outcomes, our series demon strates that good outcomes are feasible.

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