Canadian Journal of Anesthesia

, Volume 55, Issue 5, pp 276–283 | Cite as

Anesthetic management of pregnant women with sickle cell disease — effect on postnatal sickling complications

  • Julien Camous
  • Aya N’da
  • Maryse Etienne-Julan
  • François Stéphan
Reports Of Original Investigations


Purpose: Currently, there is no consensus regarding the choice of anesthetic technique for parturients with sickle cell disease (SCD). The aim of the study was to determine the impact of the anesthetic technique on the occurrence of postnatal sickling complications.

Methods: We reviewed the charts of all pregnant women with SCD who had given birth in our institution between January 2002 and January 2007. Data related to pregnancy and anesthetic management and complications related, or unrelated, to SCD were recorded. Full blood count and lactate dehydrogenase values were recorded on the day of delivery. Risk factors for postnatal sickling complications were evaluated using a logistic regression analysis to estimate odds ratios (OR) and their 95% confidence intervals (95% CI).

Results: Fourteen of the 55 women (24%) experienced at least one postnatal sickling complication. Women who developed postnatal sickling complications were found to have a higher leukocyte count (17.0±6.1×109·L−1vs 12.8±4.4×109·L−1,P=0.008) and a lower hemoglobin level (7.8±1.1vs 8.9±1.0 g.dL−1,P=0.002). General anesthesia (OR=16.0; 95% CI, 1.6 to 165.6) and a leukocyte count ⩾15×109·L−1 (OR=8.4; 95% CI, 1.6 to 44.5) were identified as risk factors. Neuraxial anesthesia and use of ephedrine were not identified as risk factors. There were no deaths.

Conclusion: Our study suggests that general anesthesia could be associated with postnatal sickling complications, even when the severity of illness was taken into account.


Sickle Cell Disease Cesarean Delivery Ropivacaine Sufentanil Regional Anesthesia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Prise en charge anesthésique de femmes enceintes souffrant d’anémie falciforme : effets sur les complications liées à la falciformation postnatale


Objectif: Il n’y a actuellement pas de consensus concernant le choix d’une technique anesthésique pour les parturientes souffrant d’anémie falciforme. L’objectif de cette étude était de déterminer l’impact de la technique anesthésique choisie sur l’incidence des complications liées à la falciformation postnatale.

Méthode: Nous avons passé en revue les dossiers de toutes les femmes enceintes souffrant d’anémie falciforme ayant accouché dans notre centre entre janvier 2002 et janvier 2007. Les données relatives à la grossesse, à la prise en charge anesthésique et aux complications associées ou non à l’anémie falciforme ont été enregistrées. Les valeurs de la formule sanguine et de lacticodéshydrogénase ont été enregistrées le jour de l’accouchement. Les facteurs de risque concernant des complications liées à la falciformation postnatale ont été évalués sur la base d’une analyse de régression logistique à des rapports de cotes estimés (RC) et à leurs intervalles de confiance 95% (IC à 95%).

Résultats: Quatorze des 55 parturientes (24%) ont montré au moins une complication liée à la falciformation postnatale. Nous avons découvert que les femmes ayant développé des complications liées à la falciformation postnatale avaient une numération des globules blancs plus élevée (17,0±6,1×109·L−1vs 12,8±4,4×109·L−1,P=0,008) et un niveau d’hémoglobine plus bas (7,8±1,1vs 8,9±1,0 g.dL−1,P=0,002). Une anesthésie générale (RC=16,0; IC à 95%, 1,6 à 165,6) et une numération des globules blancs ⩾15×109·L−1 (RC=8,4; IC à 95%, 1,6 à 44,5) ont été identifiés comme facteurs de risque. Une anesthésie neuraxiale et l’administration d’éphédrine n’ont pas été identifiés en tant que facteurs de risque. Il n’y a pas eu de décès.

Conclusion: Notre étude suggère que l’anesthésie générale pourrait être associée à des complications liées à la falciformation postnatale et ce, même lorsque la gravité de la maladie a été prise en compte.


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Copyright information

© Canadian Anesthesiologists 2008

Authors and Affiliations

  • Julien Camous
    • 1
  • Aya N’da
    • 1
  • Maryse Etienne-Julan
    • 2
  • François Stéphan
    • 1
  1. 1.From the Department of Anesthesiologythe Caribbean Centre of Sickle Cell Disease “Guy Mérault”Pointe-à-PitreFrance
  2. 2.From the Department of AnesthesiologyUniversity of French West IndiesPointe-à-PitreFrance

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