How pregnancy can affect you

Most people with sickle cell disease (SCD) will have an uncomplicated pregnancy and do not have serious problems. However, there are some problems which are more common during pregnancy, that you should be aware of. 

Sickle cell crises

Painful crises can be more common during pregnancy.  

Triggers of a sickle cell crisis include:

• cold weather
• dehydration
• too much physical activity

Here are some things you can try to help prevent a SCD crisis. 

If you are in crisis during your pregnancy

If your pain gets severe, or you are not coping at home: 

• get medical attention as soon as possible

If you are: 

• before 18 weeks gestation, go to your nearest emergency department (A&E)
• after 18 weeks gestation, go to the maternity assessment unit (MAU)

Managing a sickle cell crisis 

Before 18 weeks 

If you are before 18 weeks, you should go to the emergency department (A&E) for crises. The sickle cell team will see you in A&E as usual. If you are admitted, the team will see you each day. 

You will be given strong painkillers, oxygen to breathe, and fluids through a drip in your arm if you are dehydrated. You will also be checked for other causes of your symptoms. You may be given antibiotics.

You should also be given blood thinning (heparin) injections to reduce the risk of blood clots. You will be monitored closely, often in a high-dependency area of the hospital. Your baby’s wellbeing will be checked.

After 18 weeks

If you are unwell, and it is after 18 weeks gestation, contact the maternity assessment unit (MAU) as soon as possible. This is so that you can be seen urgently by medical staff and given treatment. Someone from the sickle cell team may also see you when you come in for assessment.

If you are concerned and are not sure what to do, you can call the sickle cell nurses, phone: 07548 152680 or 020 7188 1424, during working hours, or you can speak to the tower team midwives looking after you. 

Deep vein thrombosis (DVT)

DVT is when a blood clot forms in part of your body, usually in the legs. In pregnancy, the risk of developing blood clots in the legs is a lot higher, compared to those who are not pregnant. This risk is increased even further if you have SCD. 

Read about DVT in pregnancy.

Pulmonary embolism

There is also an increased risk of a pulmonary embolism (PE) during pregnancy. This is when a blood clot blocks a blood vessel in your lungs.

Read more about pulmonary embolism. 

Pre-eclampsia

There is a higher chance that you may get pre-eclampsia in later pregnancy if you have SCD. This causes high blood pressure and protein in your pee (urine). 

The midwives will speak to you about this during your appointment. You’ll also have your blood pressure and pee checked for signs of pre-eclampsia. 

You can read about pre-eclampsia on the NHS website. 

Other problems

SCD can also cause serious problems, such as sudden anaemia and lung problems. 

How SCD can affect your baby

SCD may affect the growth of your baby as it can affect how your placenta works.

You can find out more about this in the joint sickle-obstetrics clinic.

The joint sickle-obstetrics clinic is where you will see an obstetrician (doctor specialising in pregnancy and birth), a haematologist, a midwife, and a specialist sickle cell nurse.