Sickle cell trait and labor

While no special measures are normally required for these women during pregnancy, the story is different for labor and delivery. Virtually all experts agree that these women should be managed actively along the lines of SCD sufferers (see above).

Experience has shown that complications and rarely unexpected fatalities have occurred in women with sickle cell trait. Investigations in such cases tend to show that severe dehydration and/or hypoxia (oxygen deficiency) are the precipitating factors.

Labor and delivery should therefore be regarded as extreme conditions which could push sickle cell trait women beyond the barrier that normally makes them insusceptible to "sickling".

Monitoring of the fetus during labor in SCD

Continuous electronic fetal heart monitoring will take place for sickle cell disease sufferers.

Measures taken in the period immediately after delivery

For both SCD and sickle cell trait women, during the post-delivery period (especially the first 24 to 48 hours), the measures taken during labor will be maintained. The mainstay of these is prevention of dehydration and hypoxia.

Simple measures which ensure adequate fluid intake and rest for the mother are normally sufficient. If an infection was being treated, this should be completed.

Who is at risk of Sickle Cell?

Sickle cell disease, like the other so-called hemoglobinopathies, is a genetic disease. The defective genes are inherited from parents. The condition cannot be acquired any other way.

If one parent passes on the relevant defective gene, the child will be a carrier. That is what is known as sickle cell trait. If the defective gene is inherited from both parents, the child ends up with a complete pair of the defective genes and will have the full-blown condition known as sickle cell disease (SCD).

Ethnic propensity for Sickle Cell

Different ethnic groups are known to be more prone to different genetic conditions by virtue of their evolutionary genetic inheritance. Just like cystic fibrosis is prevalent among northern Europeans and beta-thalassemia among people of Mediterranean extraction, sickle cell disease is prevalent among people of black African origin.

The condition is also, found among people from Saudi Arabia, India and the Mediterranean areas. It is, however, less prevalent among these peoples compared to those of African ancestry.

Inter-ethnic marriages mean that the possibility of finding any of these conditions in a member of another ethnic group may be improbable but is far from impossible. In fact, the increasing trend of global population mobility, inter-ethnic marriages and partnerships mean the defective gene carrier status cannot be reliably predicted on ethnicity alone.

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