Pregnancy outcomes among patients with sickle cell disease at Korle-Bu Teaching Hospital, Accra, Ghana

Pregnancy in sickle cell disease (SCD) patients is associated with increased risk of maternal and fetal mortality. The risk varies in different geographical areas. The objective of the study was to determine the pregnancy outcomes among SCD patients admitted at the Obstetrics and Gynecology Department of Korle -Bu Teaching Hospital (KBTH), Accra, Ghana. Medical records of pregnant women from 2007-2008 were reviewed retrospectively. Records of 607 women were analyzed, of which 236 SCD patients were compared with 371 women without SCD. There were 17, 781 deliveries with 1.42% prevalence of SCD. The odds of eclampsia among women with SCD was 9.6 times that of women without SCD (95% confidence interval [CI] = 2.72-33.99, p< 0.001). Compared to women without SCD, women with SCD were less likely to have spontaneous vaginal delivery (OR = 0.26, 95% CI=0.18-0.39, p< 0.001. In this study, babies delivered by women with SCD had an increased risk of grunting respiration than other women (OR=4.4, 95% CI = 1.10-17.87, p<0.036). However, there were no significant association with stillbirth, low birth weight and intrauterine growth restriction in this study. SCD was associated with increased risk of eclampsia and cesarean section among pregnant women admitted at KBTH. SCDs are among the most common genetically transmitted conditions that have a worldwide distribution. Women with SCD can have a good reproductive outcome through appropriate counseling, good prenatal care and effective intervention by health care providers with a high index of suspicion for predisposing factors to untoward outcomes.