Pregnancy and the skeletal complications of sickle cell disease.

Introduction Sickle cell anaemia (HbSS) and sickle cell haemoglobin-C disease (HbSC) are the varieties of sickle cell disease usually encountered during pregnancy in Nigeria (Akinla, 1972). The incidence, though low, is certainly increasing. This is because young girls with a chronic haemolytic anaemia who in the past readily succumbed to intercurrent disease and malnutrition are now, with improved medical facilities, surviving to child-bearing age (Hendrickse & WatsonWilliams, 1966). The characteristic crises and other complications of sickle cell disease tend to be more frequent and more severe during pregnancy than in the nonpregnant state, and this fact has a direct bearing on the associated high maternal morbidity and perinatal mortality rates (Akinla, 1972). This is especially true of the skeletal complications. During the period from September 1966 to December 1970, forty-four patients with sickle cell disease received ante-natal care and were subsequently confined in the Obstetric Unit of the Lagos University Teaching Hospital. The Hb genotypes of these patients were as follows: HbSS, sixteen patients; HbSC, twenty-six patients; HbCC, two patients. A total of 6017 patients were managed in the unit during this period, and of these, 5465 had their Hb genotypes determined and recorded. The patients with sickle cell disease thus constituted 0-81°/ of this population. The maternal and foetal complications of the pregnancies in these patients as well as the eventual outcome have been the subject of a recent report (Akinla, 1972).