WHO Guidelines for Sickle Cell Disease Management
The World Health Organization (WHO) has introduced its first global guideline for managing sickle cell disease (SCD) during pregnancy. This initiative addresses health challenge impacting both mothers and infants. SCD is characterised by crescent-shaped red blood cells that can obstruct blood flow, leading to severe health complications. The risks associated with SCD escalate during pregnancy, increasing the likelihood of maternal mortality and obstetric complications.
About Sickle Cell Disease
Sickle cell disease is an inherited blood disorder. It causes red blood cells to become rigid and shaped like sickles. This abnormality can lead to blockages in blood vessels. Symptoms include severe pain, anaemia, and increased susceptibility to infections. The prevalence of SCD is particularly high in malaria-endemic regions, with sub-Saharan Africa accounting for the majority of cases.
Risks During Pregnancy
Pregnancy poses heightened risks for women with SCD. These women face ly increased chance of maternal death compared to those without the condition. Complications such as pre-eclampsia and adverse outcomes for the baby, including stillbirth and low birth weight, are common. The WHO guideline aims to improve these outcomes through targeted care.
WHO Guidelines
The new WHO guidelines include over 20 evidence-based recommendations. Key areas of focus are folic acid and iron supplementation, management of pain crises, and prevention of infections. The guidelines also advocate for individualised care that respects the unique needs of each woman. Addressing stigma in healthcare settings is a critical component of the recommendations.
Importance of Multidisciplinary Care
The management of SCD in pregnancy requires a skilled healthcare team. This team may include haematologists, obstetricians, midwives, and paediatricians. Collaboration among these professionals ensures comprehensive care and informed decision-making for women with SCD.
Research and Development Needs
Sickle cell disease remains under-researched and underfunded, particularly in relation to pregnant and breastfeeding women. The WHO emphasises the need for more clinical trials to evaluate treatment safety and efficacy for these populations. This guideline is part of a broader initiative to address noncommunicable diseases in pregnancy.
Government Initiatives in India
In India, the government has launched the National Sickle Cell Anaemia Eradication Mission. This initiative aims to screen millions of individuals and develop new treatment options. A investment has been announced to support drug development for SCD, particularly benefiting tribal populations disproportionately affected by the disease.
Future Directions
The WHO’s guidelines mark the beginning of a series focused on managing chronic diseases in pregnancy. Future guidelines will cover various conditions, recognising the growing impact of chronic diseases on maternal and newborn health.
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