To study the maternal and foetal outcomes in pregnancies complicated by congenital hemolytic anaemias.
Material and Methods: A retrospective descriptive study was carried out on pregnant women with hemolytic anaemias who delivered at SJMCH between January 2011 and January 2016. Antenatal and labour records were reviewed. Demographic variables like maternal age, parity, booking status, consanguinity, cause of haemolytic anaemia and time of diagnosis were noted. The primary outcome measures studied were - severity of anaemia, obstetric and medical complications, transfusion of blood and blood products and mode of delivery. Neonatal outcomes, need for ICU admission and duration of hospital stay were the secondary outcome measures studied. Data are presented as descriptive statistics, including means and percentage.
Results: Prevalence of congenital hemolytic anaemias was 0.3% (38/12420). 20 had Beta-Thalassemia; 9 Sickle cell anaemia, 7 Hereditary Spherocytosis, and 2 had enzyme defects. 13% had mild, 55% moderate, 23% severe and 5% very severe anaemia. The obstetric complications noted were pre-eclampsia (7.8%), abortions and preterm labour in 10% each, oligohydramnios and puerperal sepsis in 13% each, IUGR (23%), infections (29%), and foetal distress (31.5%). 47% had vaginal deliveries, and 52% caesarean deliveries. 42% required antenatal, 13% intrapartum and 36% postpartum transfusion of blood products. The mean birth weight of babies was 2.65 kg. 5% had PPH, none required ICU care.
Conclusion: Successful pregnancy outcomes can be achieved with prompt diagnosis, patient education, screening, genetic counselling and prenatal diagnostic testing of foetus and management in a tertiary care hospital by a multidisciplinary approach.