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Managing sickle cell disease and related complications in pregnancy: results of an international Delphi panel.
Sharma, Deva; Kozanoglu, Ilknur; Ataga, Kenneth I; Benachi, Alexandra; Büyükkurt, Selim; Lanzkron, Sophie; Ozdogu, Hakan; Pancham, Shivan; Pecker, Lydia H; Robinson, Susan E; Yilmaz Baran, Safak; Howard, Jo.
Afiliación
  • Sharma D; Vanderbilt University Medical Center, Nashville, TN.
  • Kozanoglu I; Department of Physiology, Faculty of Medicine, Baskent University, Ankara, Turkey.
  • Ataga KI; Adana Adult Bone Marrow Transplantation Center (CIC. 589), Apheresis Unit, Baskent University, Yuregir, Adana, Turkey.
  • Benachi A; Center for Sickle Cell Disease, University of Tennessee Health Science Center, Memphis, TN.
  • Büyükkurt S; Division of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Antoine Béclère Hospital, Assistance Publique Hôpitaux de Paris, Paris Saclay University Hospitals, Clamart, France.
  • Lanzkron S; Department of Obstetrics and Gynecology, Faculty of Medicine, Çukurova University, Adana, Turkey.
  • Ozdogu H; Division of Hematology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
  • Pancham S; Department of Hematology, Faculty of Medicine, Baskent University, Ankara, Turkey.
  • Pecker LH; Adana Adult Bone Marrow Transplantation Center (CIC. 589), Apheresis Unit, Baskent University, Yuregir, Adana, Turkey.
  • Robinson SE; Department of Haematology, Sandwell and West Birmingham Hospitals National Health Service Trust, West Bromwich, United Kingdom.
  • Yilmaz Baran S; Division of Hematology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
  • Howard J; Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD.
Blood Adv ; 8(4): 1018-1029, 2024 02 27.
Article en En | MEDLINE | ID: mdl-38206762
ABSTRACT
ABSTRACT Data to guide evidence-based management of pregnant people with sickle cell disease (SCD) are limited. This international Delphi panel aimed to identify consensus among multidisciplinary experts for SCD management during pregnancy. The 2-round Delphi process used questionnaires exploring 7 topics (antenatal care, hydroxyurea use, transfusion, prevention of complications, treatment of complications, delivery and follow-up, and bottlenecks and knowledge gaps) developed by a steering committee. Thirteen panelists (hematologists, physiologists, obstetricians, maternal fetal medicine, and transfusion medicine physicians) from the United States, the United Kingdom, Turkey, and France completed the first survey; 12 panelists completed the second round. Anonymized responses were collected and summarized by a contract research organization (Akkodis Belgium). Consensus and strong consensus were predefined as 75% to 90% (9-10 of 12) and >90% (≥11 of 12) of panelists, respectively, agreeing or disagreeing on a response to a predefined clinical scenario or statement. In several areas of SCD management, consensus was achieved experts recommended performing at least monthly multidisciplinary antenatal follow-up, administering prophylactic aspirin for preeclampsia prevention between gestational weeks 12 and 36, initiating prophylactic transfusion therapy in certain cases, or choosing automated red blood cell exchange over other transfusion methods for patients with iron overload or severe acute chest syndrome. No consensus was reached on several topics including the prophylactic aspirin dose, indications for starting infection prophylaxis, routine use of prophylactic transfusions, or use of prophylactic transfusions for preventing fetal complications. These recommendations could inform clinical care for patients with SCD who are pregnant in the absence of large clinical trials involving this population; the identified knowledge gaps can orient future research.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome Torácico Agudo / Anemia de Células Falciformes Tipo de estudio: Guideline / Qualitative_research Límite: Female / Humans / Pregnancy Idioma: En Revista: Blood Adv Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome Torácico Agudo / Anemia de Células Falciformes Tipo de estudio: Guideline / Qualitative_research Límite: Female / Humans / Pregnancy Idioma: En Revista: Blood Adv Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos