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. |