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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.

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Galiba Atipo Tsiba, F., Ngolet Ocini, L., Itoua, C., Bintsene-Mpika, G., Malanda, F., Boukinda Doukaga, D., & Elira Dokekias, A. (2019). Drépanocytose et Grossesse: Expérience du Centre National de Référence de la Drépanocytose de Brazzaville. HEALTH SCIENCES AND DISEASE, 20(2). https://doi.org/10.5281/hsd.v20i2.1294
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References

  1. Elion J, Laurance S, Lapouméroulie C. Physiopathologie de la drépanocytose. Med Trop 2010;70:454-58.
  2. Labie D, Elion J. La drépanocytose : problème de l’Afrique. Med Trop 2010;70:449-53.
  3. Oteng-Ntim E, Meeks D, Seed PT, Webster L, Howard J, Doyle P et al. Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis. Blood. 2015;125(21):3316-25.
  4. Iloki LH, Eouani LM, Ekoundzola JR. Drépanocytose homozygote et grossesse : A propos de 12 cas observés au CHU de Brazzaville (Congo). Rev Fr Gynécol Obstét 1996;91(5):243-46.
  5. Muganyizi PS, Kidanto H. Sickle Cell Disease in Pregnancy: Trend and Pregnancy Outcomes at a Tertiary Hospital in Tanzania. PLoS ONE 2013;8(2): 1-5.
  6. Boulet SL, Okoroh EM, Azonobi I, Grant A, and Hooper WC. Sickle Cell Disease in Pregnancy: Maternal Complications in a Medicaid-Enrolled Population. Matern Child Health J. 2013;17(2):200-07.
  7. Oteng-Ntim E, Ayensah B, Knight M, Howard J. Pregnancy outcome in patients with sickle cell disease in the UK-a national cohort study comparing sickle cell anemia (HbSS) with SC disease. BJH 2015;169:129-37.
  8. Hernández-Padrón C, Del Loreto Téllez M, Espinosa-Estrada E, Ramón-Rodríguez LG, Ávila-Cabrera OM, Pujadas-Ríos X et al. Sickle cell disease and pregnancy. Experience at the Instituto de Hematologia e Inmunología, Cuba. Rev Cubana Hematol. 2012;28(4):416-22.
  9. Wilson NO, Ceesay FK, Hibbert JM, Driss A, Obed SA, Adjei AA et al. Pregnancy outcomes among patients with sickle cell disease at Korle-Bu Teaching Hospital, Accra, Ghana: retrospective cohort study. Am J Trop Med Hyg. 2012;86(6):936-42.
  10. Elenga N, Adeline A, Balcaen J, Vaz T, Calvez M, Terraz A et al. Pregnancy in sickle cell disease is a very high-risk situation: an observational study. Obstet Gynecol Int. 2016;2016:1-5.
  11. Desai G, Anand A, Shah P, Shah S, Dave K, Bhatt H et al. Sickle cell disease and pregnancy outcomes: a study of the community based hospital in a tribal block of Gujarat, India. J Health Popul Nutr 2017;36(3):1-7.
  13. Kar TJ, Baru L, Bhoi G, Patnaik R. Fetomaternal outcome in sickle cell hemoglobinopathy. GJRA 2018;7(2) :83-86.
  14. Okusanya BO, Oladapo OT. Prophylactic versus selective blood transfusion for sickle cell disease in pregnancy. Cochrane Database Syst Rev 2016;12:1-29.
  15. Parrish MR and Morrison JC. Sickle cell crisis and pregnancy. Semin Perinatol. 2013;37(4):274-9.
  16. Asma S, Kozanoglu I, Tarım E, Sarıturk C, Gereklioglu C, Akdeniz A et al. Prophylactic red blood cell exchange may be beneficial in the management of sickle cell disease in pregnancy. Transfusion 2015;55(1):36-44.
  17. Tshilolo LM, Mukendi RK, Wembonyama SO. Blood transfusion rate in Congolese patients with sickle cell anemia. Indian J Pediatr. 2007;74(8) :735-8.
  18. Batina Agasa S, Dupont E, Kayembe T, Molima P, Malengela R, Kabemba S et al. Multiple transfusions for sickle cell disease in the Democratic Republic of Congo: the importance of the hepatitis C virus. Transfus Clin Biol 2010;17(4):254-9.
  19. Camous J, N’da A, Etienne-Julan M, Stéphan F. Anesthetic management of pregnant women with sickle cell disease - effect on postnatal sickling complications. Can J Anesth 2008;55(5):276-83.
  20. Habibi A, Arlet JB, Stankovic K, Gellen-Dautremer J, Ribeil JA, Bartolucci P et al. Recommandations françaises de prise en charge de la drépanocytose de l’adulte : actualisation 2015. Rev Med Interne. 2015;36(5):5S3-84.
  21. Al-Jufairi Z, Sandhu A. Maternal Mortality in Women with Sickle Cell Disease. Bahrain Med Bull 2014;36(4):1-7.

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