Outcome of Pregnancies Among Sickle Cell Patients Admitted to Cotonou University Hospitals (Benin) from 2008 to 2018
Journal of Gynecology and Obstetrics
Volume 8, Issue 6, November 2020, Pages: 154-160
Received: Sep. 4, 2020; Accepted: Sep. 21, 2020; Published: Oct. 30, 2020
Views 39      Downloads 22
Authors
Dangbemey Djima Patrice, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Tognifode Veronique, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Azonbakin Simon, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Tchiakpe-Enialoko Nicole, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Aboubakar Moufalilou, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Ogoudjobi Mathieu, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Lokossou Symphorose, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Nzikou Venance, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Tshabu-Aguemon Christiane, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Hounkpatin Benjamin, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Tonato-Bagnan Josiane, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Denakpo Lewis, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Article Tools
Follow on us
Abstract
Objective: Study the fetal-maternal and neonantal prognosis of sickle cell pregnancies managed in Cotonou’s hospitals (R. Benin). Material and methods: This is a descriptive study on retrospective data from January 2008 to December 2018. The maternities of the Lagoon Mother and Child Hospital and University (CHU-MEL) center and of the CNHU/HKM gynecology and obstetrics university clinic had served as a framework. Complete patients records were analyzed. Included were pregnant women or delivered at 28 weeks of amenorrhea (AW) or beyond, sickle cell disease SS or SC confirmed by hemoglobin electrophoresis. Sociodemographic, clinical, therapeutic, and fetal-maternal and neonatal prognosis were analyzed. EPI DATA 3.1 and SPSS 2.0 software were used to analyze our data. The difference is significant for a p-value ≤ 5%. Ethical and professional standards and rules were respected. Results: The delivery of a patient suffering from sickle cell disease represented 0.82% of births. The SS phenotype was observed in 27.3% (n=105) versus 72.7% (n=279) of SC (p=0.000). A history of obstetric complications was noted in 56.8% (n=218). The course of the current pregnancy was marked by obstetric complications in 97.4% and the most important were: the threat of premature delivery (28%) and the vaso-occlusive crisis (19.5%). The caesarean was performed in 92% of sickle cell patients. Premature delivery was observed in 60% with 6.3% very premature (28-33AW). It was registered 91% (n=352) live births, 48% (n=169) hypotrophs, 60% premature, 1.1% (n=4) intrapartum deaths and 8% (n=4) intrapartum deaths and 8% (n=31) deaths in utero. Perinatal mortality represented 9%. The after-effects of childbirth were complicated in 12% (n=46). The puerperal infections (32.6%), hypertension (28.2%) and its complications and severe anemia (19.2%) were the most common complications. Five (5) maternal deaths were deplored, ie a mortality rate of 1420 maternal deaths per 100,000 live births. Conclusion: In Benin, pregnancy and delivery of sickle cell disease are at high risk of fetal, maternal and neonatal mortality. Caesarean section was almost routine in this group. The practice of transfusion exchange or bleeding may improve prognosis.
Keywords
Pregnancy, Sickle Cell Disease, Mortality, Benin
To cite this article
Dangbemey Djima Patrice, Tognifode Veronique, Azonbakin Simon, Tchiakpe-Enialoko Nicole, Aboubakar Moufalilou, Ogoudjobi Mathieu, Lokossou Symphorose, Nzikou Venance, Tshabu-Aguemon Christiane, Hounkpatin Benjamin, Tonato-Bagnan Josiane, Denakpo Lewis, Outcome of Pregnancies Among Sickle Cell Patients Admitted to Cotonou University Hospitals (Benin) from 2008 to 2018, Journal of Gynecology and Obstetrics. Vol. 8, No. 6, 2020, pp. 154-160. doi: 10.11648/j.jgo.20200806.11
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
C. Arnal; R Girot. Drépanocytose chez l’adulte. Encycl Méd Chir. Editions Scientifiques et Médicales. Elsevier SAS, Paris, Hématologie, 13-006-D-16, 2002; 15 p.
[2]
Arnal C, Girot R. Drépanocytose chez l’adulte. Encycl Med Chir (Editions Scientifiques et Médicales Elsevier SAS, Paris, tous droit réserves).2002; 13-006-D-16, 15 p.
[3]
Bourbillon. A. Pédiatrie pour le praticien 6è édition; Elsevier; Masson; 2011; p 46.
[4]
Houndeffo T, Adisso S, Tshabu-Aguemon C, Rahimy Mc. Houssou F. K, De Souza J, Takpara I, Alihonou E. Issue de la grossesse chez les drépanocytaires. Journal de la Société de Biologie Clinique, 2013; N° 018; 36-42.
[5]
Janky E, Etienne-julan M, Kadhel PH, Leborgne-samuel Y, Melki E. Drépanocytose et Grossesse. Collège National Des Gynécologues et Obstétriciens Français. Tome XXX. Publié au trentième Journées nationales Paris, le 29.11.2006.
[6]
Institut National de la Statistique et de l’Analyse Economique (INSAE) et ICFINSAE. Enquête Démographique et de Santé au Bénin (EDSB); 2018 2017-2018: indicateurs Clés. Cotonou, Bénin et Rocville, Maryland, USAINSAE et ICF. P 15-16.
[7]
Organisation Mondiale de la Santé. Drépanocytose. Rapport du secrétariat 59è Assemblée mondiale de la santé 2006) Drépanocytose. WHA59/2006/REC/3.
[8]
Diallo DA, Guindo A, Touré BA, Sarro YS, Sima M, Tessougué O, Baraika MA, Guindo P, Traoré M, Diallo M, Dorie A. Dépistage néonatal ciblé de la drépanocytose: limites du test de falciformation (test d’Emmel) dans le bilan prénatal ouest africaine. Revue d’Epidémiologie et de Santé Publique xxx (2018) xxx.
[9]
Elie Nkwabonga, Pernelle Ngoundjou Dongmob, Claude Tayouc and Theophile Nana Njamend. Outcome of pregnancies among women with sickle cell disease. The journal of maternal-fetal & neonatal medicine https://doi.org/10.1080/14767058.2020.1743657.
[10]
Kelly Kuo, Aaron B Caughey. Contemporary outcomes of sickle cell disease in pregnancy. Am J Obstet Gynecol. 2016 Oct; 215 (4): 505. e1-5. doi: 10.1016/j.ajog.2016.05.032. Epub 2016 May 27.
[11]
J. B. Arlet. Avancées thérapeutiques dans la drépanocytose: vers les thérapies ciblées. 2020; 41: 73-77.
[12]
Diop S, Mokono S. O, Ndiaye M, Touré Fall A. O, Thiam D, Diakhaté L. La drépanocytose homozygote après l’âge de 20 ans: suivi d’une cohorte de 108 patients au CHU de Dakar. La revue de médecine interne 24 (2003) 711–715.
[13]
N. Lélicée, F. Venditteli, S. Ughetto, E. Janky. La qualité du suivi de la grossesse interfère -elle avec les issues de la grossesse, en Guadeloupe? Gynécologie obstétrique et fertilité (41) 2013 282-288.
[14]
Chantal Lagresle-Peyrou, François Lefrère, Elisa Magrin, Jean-Antoine Ribeil, Oriana Romano, Leslie Weber, Alessandra Magnani, Hanem Sadek, Clémence Plantier, Aurélie Gabrion, Brigitte Ternaux, Tristan Félix Chloé Couzin, Aurélie Stanislas, Jean-Marc Tréluyer, Lionel Lamhaut, Laure Joseph, Marianne Delville, Annarita Miccio, Isabelle André-Schmutz Marina Cavazzana. Plerixafor enables safe, rapid, efficient mobilization of hematopoietic stem cells in sickle cell disease patients after exchange transfusion. Haematologica. 2018 May; 103 (5): 778-786. doi: 10.3324/haematol.2017.184788.
[15]
Elizabeth Biller, Yong Zhao, Mary Berg, Lisa Boggio, Kelley E Capocelli, Deanna C Fang, Scott Koepsell, Lejla Music-Aplenc, Huy P Pham, Angela Treml, John Weiss, Geoffrey Wool, Beverly W Baron. Red blood cell exchange in patients with sickle cell disease-indications and management: a review and consensus report by the therapeutic apheresis subsection of the AABB. Transfusion 2018 Aug; 58 (8): 1965-1972. doi: 10.1111/trf.14806.
[16]
Patel S, Purohit, P., Jit, B. P., & Meher, S. (2019). Pregnancy outcomes in women with sickle cell disease: a retrospective study from Eastern India. Journal of Obstetrics and Gynaecology 2019: 39 (6), 882–884. https://doi.org/10.1080/01443615.2019.1571024.
[17]
M. de Montalembert. Pathologies maternelles et grossesse. Drépanocytose et période néonatale. J Gynecol Obstet Biol Reprod 2004; 33 (suppl. au n° 1): 1S12-1S14.
[18]
Can Boga, Hakan Ozdogu. Pregnancy and sickle cell disease: A review of the current literature. Crit Rev Oncol Hematol2016 Feb; 98: 364-74. doi: 10.1016/j.critrevonc.2015.11.018.
[19]
Amanda Redden Hathaway. Sickle Cell Disease in Pregnancy. South Med J 2016 Sep; 109 (9): 554-6. doi: 10.14423/SMJ.0000000000000514.
[20]
Evelyn Bae, Virginia Tangel, Nathan Liu, Sharon E Abramovitz, Robert S White. Inpatient mortality and postpartum readmission rates in sickle cell disease pregnancies: a multistate analysis, 2007-2014. J Matern Fetal Neonatal Med 2019 Oct 6; 1-10. doi: 10.1080/14767058.2019.1671333.
[21]
N Lesage, C Deneux Tharaux, M Saucedo, A Habibi, F Galacteros, R Girot, M H Bouvier Colle, G Kayem. Maternal mortality among women with sickle-cell disease in France, 1996-2009. Eur J Obstet Gynecol Reprod Biol 2015 Nov; 194: 183-8. doi: 10.1016/j.ejogrb.2015.09.016.
[22]
Neeta Natu, Seema Khandelwal, Ravindra Kumar, Anupama Dave. Maternal and perinatal outcome of women with sickle cell disease of a tribal population in Central India. Hemoglobin. 2014; 38 (2): 91-4. doi: 10.3109/03630269.2013.869501.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186