Table 1.

Preconception care for women with sickle cell disease

1. If pregnancy not desired, address contraception approach 
2. Hemoglobin electrophoresis for reproductive partners with interpretation 
3. Genetic counseling 
4. Changes to SCD treatment during conception, pregnancy 
5. Changes to usual medicines (ie, discontinue NSAIDs, chelators, ACE-I/ARB; start prenatal vitamin) 
6. Review historic complications that can affect pregnancy or worsen during pregnancy (ie, AVN, renal disease, cardiopulmonary disease, acute chest, pain, retinopathy) 
7. Plan for multidisciplinary high-risk obstetrics and SCD care 
These are the main themes of preconception counseling for women with SCD. Results from the first 2 steps may direct care in additional directions, such as for gynecology or reproductive endocrinology/infertility care. 
ACE-I, angiotensin-converting enzyme inhibitors, ARB, angiotensin receptor blocker, NSAIDs, nonsteroidal anti-inflammatory drugs. 
1. If pregnancy not desired, address contraception approach 
2. Hemoglobin electrophoresis for reproductive partners with interpretation 
3. Genetic counseling 
4. Changes to SCD treatment during conception, pregnancy 
5. Changes to usual medicines (ie, discontinue NSAIDs, chelators, ACE-I/ARB; start prenatal vitamin) 
6. Review historic complications that can affect pregnancy or worsen during pregnancy (ie, AVN, renal disease, cardiopulmonary disease, acute chest, pain, retinopathy) 
7. Plan for multidisciplinary high-risk obstetrics and SCD care 
These are the main themes of preconception counseling for women with SCD. Results from the first 2 steps may direct care in additional directions, such as for gynecology or reproductive endocrinology/infertility care. 
ACE-I, angiotensin-converting enzyme inhibitors, ARB, angiotensin receptor blocker, NSAIDs, nonsteroidal anti-inflammatory drugs. 
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