Drépanocytose et Grossesse: Expérience du Centre National de Référence de la Drépanocytose de Brazzaville

FO Galiba Atipo Tsiba, L Ngolet Ocini, C Itoua, G Bintsene-Mpika, F Malanda, D Boukinda Doukaga, A Elira Dokekias

Abstract



RÉSUMÉ
Introduction. La drépanocytose homozygote SS associe une anémie hémolytique chronique et des complications vaso-occlusives et infectieuses. L’association drépanocytose - grossesse est une situation à haut risque maternel et fœtal. Ce travail avait pour objectif de décrire le déroulement de ces grossesses au Centre National de Référence de la Drépanocytose et dans le service d’Obstétrique du CHU, à Brazzaville. Matériels et méthodes. Étude transversale rétrospective réalisée sur une période de 24 mois. Nous avons inclus les dossiers des gestantes atteintes de drépanocytose SS, suivies jusqu’au 3ème trimestre. Le suivi était mensuel ; les paramètres analysés étaient les complications maternelles et fœtales, l’activité transfusionnelle, le mode d’accouchement, l’issue des grossesses. La moyenne arithmétique a été le seul test statistique utilisé. Résultats. Vingt-deux dossiers ont été retenus (20 grossesses monofœtales et deux gémellaires). L’âge moyen des femmes était de 28,7 ans [23 ans – 38 ans]. Les complications maternelles ont été: aggravation de l’anémie (22/22), crises vaso-occlusives (10/22), infections (8/22), thrombose veineuse profonde (2/22), syndrome thoracique aigu (1/22), pré-éclampsie (1/22). Les complications fœtales ont été: retard de croissance (3/22), mort fœtale in utero (2/22). Toutes les gestantes ont été transfusées au moins une fois. Le type d’accouchement était : voie basse (8/22), césarienne (14/22), prématurité (6/22). L’issue a été : décès maternel (0/22), décès nouveau-né (4/24). Conclusion. L’association drépanocytose homozygote SS – grossesse est responsable d’une morbidité maternelle et fœtale importante. Un suivi médical régulier de la gestante peut permettre de mener à bien la grossesse.

ABSTRACT
Introduction. SS homozygous sickle cell disease is associated with chronic hemolytic anemia vaso-occlusive and infectious complications. Sickle cell disease - pregnancy is a high risk maternal and fetal situation. The purpose of this work was to describe the evolution of pregnancies at the National Reference Sickle Cell Disease Center and in the Obstetrics department of the University Hospital in Brazzaville. Materials and methods. Retrospective cross-sectional study carried out over a period of 24 months. The records of pregnant women with Sickle Cell Disease were Included were, with a followed up to the 3rd trimester. This follow-up was monthly. The analyzed parameters were: maternal and fetal complications, transfusion activity, the mode of delivery, the outcome of pregnancies. The arithmetic mean was the only statistical test used. Results. Twenty-two files were collected. The average age was 28.7 years [23 years - 38 years]. Maternal complications were: aggravation of anemia (22/22), vaso-occlusive attacks (10/22), infections (8/22), deep vein thrombosis (2/22), acute thoracic syndrome (1/22), preeclampsia (1/22). Fetal complications were: stunting (3/22), in utero fetal death (2/22). All women were transfused at least once. Delivery: vaginal way (8/22), caesarean (14/22), prematurity (6/22). Outcome was: maternal death (0/22), newborn death (4/24). Conclusion. Homozygous Sickle cell disease - pregnancy is responsible of significant maternal and fetal morbidity. Regular medical monitoring of the pregnancy can help to reduce this trend.


Keywords


drépanocytose homozygote SS, grossesse, morbidité, mortalité, Brazzaville

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