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Pregnancies in patients with sickle cell disease (SCD) are associated with increased maternal and fetal morbidity and mortality. Transfusing normal red cells increases hemoglobin and decreases the percentage of red cells bearing sickle hemoglobin in the maternal circulation, enhancing tissue perfusion and oxygenation.
To assess whether transfusion reduces the frequency of pain crises and improves pregnancy outcomes, investigators conducted a systematic review and meta-analysis of a dozen studies of simple or exchange transfusions in 1291 patients with hemoglobins SS, SC, or Sβ-thalassemia. Transfusion was given either prophylactically to achieve a target hemoglobin of ≤50% HbS or on-demand because of severe anemia or SCD complications.
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