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Manual Exchange Transfusion Role in the Management of a Pregnancy Compromised by Sickle Cell Disease in a Tertiary Hospital in Burkina Faso: A Case Report,
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Discipline: Médecine clinique
Auteur(s): Djerma Corneille Ydris1, Sanogo Moussa, Sib Sansan Rodrigue, Ouedraogo Salam, Kafando Amadou, Yameogo Barnabé, Sawadogo Salam, Nébié Yacouba, Kafando Eléonore
Auteur(s) tagués: SAWADOGO Salam
Renseignée par : SAWADOGO Salam
Résumé

Sickle cell disease in pregnant women can lead to potentially serious complications for both the mother and fetus. Its
management remains a major public health challenge, particularly in resource-limited regions. Here, we report the management
of a case at the Regional University Hospital (RUH) of Ouahigouya. A 30-year-old patient with 2 pregnancies, 1 miscarriage
following a vaso-occlusive crisis. The current pregnancy was monitored at a peripheral health center until 25 weeks of gestation
when the patient experienced a vaso-occlusive crisis, prompting her evacuation to the CHUR-OHG. Electrophoresis of
hemoglobin revealed 53% hemoglobin S fraction and 47% hemoglobin C fraction, with mild anemia at 9.6g/dl. After
symptomatic treatment and hydration, the first crisis improved; however, due to the succession of crises, manual exchange
transfusion was discussed and indicated by the care team. Initially, this exchange was not performed due to a lack of blood
products. Thanks to the opening of the new transfusion center in the region, the required blood bags were available for the
procedure. Manual exchange transfusion was performed, using AA red blood cell concentrate. The immediate aftermath of the
exchange transfusion was straightforward, and the patient was able to carry her pregnancy to term without further complications.
Delivery was by caesarean section, at 38 weeks of gestation. The newborn, a female, had Apgar scores of 9/10 and 10/10, with a
weight of 2600 grams. Postoperative recovery was uneventful with no vaso-occlusive crises.

Mots-clés

Sickle Cell Disease, Pregnancy, Vaso-Occlusive Crises

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