Implementation of multidisciplinary care reduces maternal mortality in women with sickle cell disease living in low-resource setting

American Journal of Hematology
Eugenia Vicky AsareSamuel A Oppong

Abstract

Sickle cell disease (SCD) is associated with adverse pregnancy outcome. In women with SCD living in low-resource settings, pregnancy is associated with significantly increased maternal and perinatal mortality rates. We tested the hypothesis that implementing a multidisciplinary obstetric and hematology care team in a low-resource setting would significantly reduce maternal and perinatal mortality rates. We conducted a before-and-after study, at the Korle-Bu Teaching Hospital in Accra, Ghana, to evaluate the effect of a multidisciplinary obstetric-hematology care team for women with SCD in a combined SCD-Obstetric Clinic. The pre-intervention period was assessed through a retrospective chart review to identify every death and the post-intervention period was assessed prospectively. Interventions consisted of joint obstetrician and hematologist outpatient and acute inpatient reviews, close maternal and fetal surveillance, and simple protocols for management of acute chest syndrome and acute pain episodes. Primary outcomes included maternal and perinatal mortality rates before and after the study period. A total of 158 and 90 pregnant women with SCD were evaluated in the pre- and post- intervention periods, respectively. The mater...Continue Reading

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Citations

Apr 17, 2018·American Journal of Hematology·Eugenia Vicky AsareSamuel A Oppong
Oct 2, 2019·American Journal of Hematology·Eugenia Vicky AsareSamuel A Oppong
Oct 8, 2019·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Evelyn BaeRobert S White
Dec 7, 2019·Hematology·Kim Smith-Whitley
Aug 31, 2019·Annals of the American Thoracic Society·A Parker RuhlElizabeth S Klings
Jan 31, 2019·Molecular Genetics & Genomic Medicine·Jessica DuisJennifer L Miller
Mar 16, 2021·Hematology, Transfusion and Cell Therapy·Viviane Teixeira de SousaRodolfo D Cancado
Mar 9, 2021·BJOG : an International Journal of Obstetrics and Gynaecology·G LewisG R Serjeant
May 14, 2021·American Journal of Hematology·Charles F Hayfron-BenjaminSamuel A Oppong
Dec 11, 2021·Hematology·Hyojeong HanVenée N Tubman

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