The placental-umbilical unit in sickle cell disease pregnancy: a model for studying in vivo functional adjustments to hypoxia in humans.

The placental-umbilical unit in sickle cell disease (SCD) pregnancy was used to explore hypoxia in vivo, an important factor in the pathophysiology of this disease. Gross examination and microscopic analysis of the placentas, taken immediately after delivery, indicate good concordance between maturity and term as controls, but higher frequency of vascular injuries such as excess syncytial knots, excess fibrin deposits, congestion and villous necroses. Unexpectedly, neither leukocyte recruitment nor alteration in extraplacental membrane was observed, suggesting the absence of inflammation.

[Sickle cell disease and pregnancy].

Pregnancy in SCD women, with a major sickle cell syndrome, is a high-risk situation and is associated with raised incidence of maternal and fetal morbidity and mortality, mainly in late pregnancy, during delivery and in the postpartal periods. Pregnancy increases the incidence of sickle cell specific complications such as anaemia, vaso-occlusive crisis, abdominal, pulmonary (acute chest syndrome) or placental thrombosis, infections (urinary tract infection, pyelonephritis, pneumonia), and toxemia. Maternal death can occur.

[Analysis of hospitalization of adult sickle-cell patients in Guadeloupe].

Purpose: To determine the characteristics of acute hospitalizations in adult patient with sickle-cell disease in Guadeloupe.

Methods: We retrospectively studied clinical features of adult patients followed up by the "Centre Caribeen de la Drépanocytose" (CCD) in 1996. Data were collected from the medical records of the hospitalized patients and the longitudinal records of the CCD.

[Sickle cell anemia and pregnancy: review of 68 cases in Guadeloupe].

Pregnancy in women with major sickle cell syndromes is a high risk maternofetal situation. This descriptive study presents the features and the clinical course of 68 pregnancies in sickle cell women who were delivered in Guadeloupe from January 1(st) 1993 to December 31(st) 1997. Specific complications were observed in all hemoglobin types, but with a severer course in SS women.

Morphological features of the human umbilical vein in normal, sickle cell trait, and sickle cell disease pregnancies.

Pathological changes often occur in the placenta of women with sickle cell disease (SCD). These alterations are caused by sickling of erythrocytes and vasoocclusion in the placental circulation, leading to regional hypoxia. However, the morphological status of the umbilical cord, which is in close physical association with the placenta, is not documented under such conditions.