Page 210 - Critical Maternity & Newborn Health Nursing
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1- Feature of anemia and hemolytic jaundice.
2- Multiple infarcts due to obstruction of microcirculation in the spleen,
kidney, CNS, retina, bone, lungs, and heart.
3- Increased susceptibility to infections especially urinary.
4- Attacks of severe abdominal pain and fever are common due to
ischemia and infarctions.
5- Pre-eclampsia like- syndrome with hypertension, edema and proteinuria
may develop.
6- Increased fetal wastage from abortion, preterm labor and growth
retardation associated with placenta! insufficiency due to maternal
placental bed thrombosis.
Management of sickle cell disease during labor:
1- Avoid: hypoxia, dehydration, and acidosis.
2- Treat crises by rehydration, bicarbonate, analgesic, heparin or low
molecular weight dextran.
3- Prophylactic antibiotic.
Investigations of Hemolytic Anemia:
1. Serum bilirubin: raised.
2. Urine: increased urobilinogen.
3. Stool: increased stercobilinogen.
4. Blood film: shows normocytic normochromic anemia and.
• Small spherical RBCs in case of spherocytosis.
• Target cells in case of Thalassemia major.
• Sickling after inducing hypoxia by addition of Na bisulphite in case
of sickle cell anemia.
5. Electrophoresis: detect type of hemoglobin in haemoglobinopathies.
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