Laboratory tests for monitoring prophylactic exchange transfusion in pregnancy complicated by sickle cell disease

• Published in: Clinical and laboratory haematology Vol. 10; no. 3; p. 243
• Main Authors: Keidan, A J, Marwah, S S, Bareford, D, Franklin, I M, Stuart, J
• Format: Journal Article
• Language: English
• Published: England 01-09-1988
• Subjects: Anemia, Sickle Cell - therapy; Exchange Transfusion, Whole Blood; Female; Humans; Monitoring, Physiologic; Pregnancy; Pregnancy Complications, Hematologic - therapy; Pregnancy Outcome; Prospective Studies
• ISSN: 0141-9854
• DOI: 10.1111/j.1365-2257.1988.tb00017.x

Prophylactic exchange transfusion is of uncertain value in pregnancy complicated by sickle cell disease (SCD), and there is a lack of laboratory tests to monitor its effect and determine the optimal number and frequency of transfusions. In a prospective study of four consecutive pregnancies complicated by SCD, the product of the PCV and percentage of haemoglobin S gave a 'sicklecrit' value that showed a significant (P less than 0.01) improvement following transfusion. Erythrocyte filterability through pores of 5 microns diameter also improved significantly (P less than 0.05) whereas whole blood viscosity did not, owing to the overriding effect of the increase in PCV. Measurement of sicklecrit and erythrocyte filterability, reflecting blood rheology in large and small vessels respectively, may therefore be used to monitor the effects of exchange transfusion in SCD.