PMM.33 Twin pregnancy in maternal sickle cell disease: identifying learning points for successful outcome

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Abstract

Background

Sickle cell disease (SCD) and multiple pregnancies have both independently been associated with adverse pregnancy outcomes. Through our case series we observe the impact of multiple pregnancy on SCD morbidity, on which there is currently limited data. With multidisciplinary and protocol driven care, we identify a pathway, which could positively influence outcome.

Methods

Retrospective case-note based study in a tertiary referral unit over nine years in a combined obstetric-haematology clinic. 240 pregnant women with SCD were seen in the study period; nine with twin gestation.

Results

There were no cases of maternal or fetal mortality. Irrespective of chorionicity, SCD pregnancies had more preterm deliveries and delivered lower birth weight centile babies.

Conclusion

Our case series has demonstrated better overall pregnancy outcome compared to the limited published literature. Although numbers are small to derive robust conclusions, we suggest where managed in a dedicated setup, these women can have successful outcomes. However, they are at risk of increased perinatal and maternal morbidity. We propose vigilant surveillance from the first trimester, with a defined care-plan and extensive collaboration between experienced multidisciplinary teams.

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