Prophylactic versus selective blood transfusion for sickle cell anaemia during pregnancy.

BACKGROUND

Sickle cells have a shorter life span than normal red blood cells. It has been suggested that pregnancy complications for women with sickle cell anaemia may be reduced by regular blood transfusions. The aim is to maintain haemoglobin at 60-70% of the normal total.

OBJECTIVES

The objective of this review was to assess the effects of a policy of routine blood transfusion for pregnant women with sickle cell disease with a policy of selective transfusion.

SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register was searched.

SELECTION CRITERIA: Acceptably controlled trials of blood transfusion in pregnant women with sickle cell disease.

DATA COLLECTION AND ANALYSIS: Eligibility, trial quality assessment and data extraction were done by one reviewer.

MAIN

RESULTS

One trial involving 72 women was included. Half the women received blood transfusion only if haemoglobin fell below 6g% and the other half received two units of blood every week for three weeks, or until haemoglobin level was 10-11g%. A policy of selective transfusion reduced the number of transfusions required at the expense of more frequent pain crises.

REVIEWER'S

CONCLUSIONS

There is not enough evidence to draw conclusions about the prophylactic use of blood transfusion for sickle cell anaemia during pregnancy.