Gravidez na paciente com doença falciforme: resultados maternos e perinatais

Abstract

Pregnant women with sickle cell disease (SCD) have more obstetric, perinatal, hematological complications them without SCD. This study aimed to compare the results of maternal and perinatal in patients with the SCD with a group without SCD, prospectively, from January 2009 to August 2011, which was accompanied by both obstetricians and hematologists using the same protocol of care. We studied 60 pregnancies (30 HbSS and 30 HbSC) compared with 192 pregnancies in patients without SCD. We found significant differences between the study group and control in relation to gestational age at delivery (p = 0.000; OR = 4,96), cesarean section rate (p = 0.000; OR = 5.00), deep vein thrombosis (p = 0.003), urinary infection (p = 0.001; OR = 3.31) birth weight (0.000, HbSS = 2080g; HbSC = 2737.5 g; control = 3035g), small for gestational age (p = 0.019; OR = 2.66), admission to the UNCP (0.000; OR = 4.89). There was a trend toward statistical significance rate of maternal death (p = 0.056). When analyzing subgroups SS and SC observed that the above findings were more frequent in patients with HbSS. Multivariate analysis to assess the factors related to prematurity in the study group showed that the painful crises and genotype are factors that contribute to prematurity. We conclude that SCD patients have more complications maternal and fetal that the general population, and the HbSS subgroup of these complications were more evident. The monitoring in conjunction with the hematology service can improve these results.