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Scholars Journal of Medical Case Reports | Volume-7 | Issue-06
Drepanocytosis and Pregnancy: About a Clinical Case
Khalid Lahmadi, Imane Benbella, Mohamed Sbiti, Mohamed Er-rami, Lhoucine Louzi
Published: June 30, 2019 |
176
182
DOI: 10.36347/sjmcr.2019.v07i06.003
Pages: 385–387
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Abstract
Sickle cell disease is a genetic disorder characterized by the presence of abnormal hemoglobin: Hb S whose polymerization in the deoxygenated state is responsible for the clinical manifestations of the disease: anemia and vaso-occlusive seizures. The occurrence of a pregnancy in a sickle cell woman is a risk situation for both the mother and the fetus, in view of the worsening clinical signs of the disease, to which are added obstetric complications. We report, a case of sickle cell disease in a woman of 22 years, G1P1, without significant pathological antecedents, followed at the gynecology department of the Military Hospital Moulay Ismail MEKNES with a gestational age of 12 weeks of amenorrhea. In her systematic pregnancy assessment, the blood count showed leukocytosis at 31000 / mm3, normochromic regenerative normocytic anemia (Hb: 8 g / dl, VGM: 80fl, TCMH: 29.2 pg, MCHC: 30.1 g reticulocytes: 145,000 / mm3). In front of this leukocytosis, a colored blood smear with MGG is carried out and showed the presence of 70% of circulating erythroblasts and the presence of numerous sickle cells. A sickling test is done and found to be positive. The diagnosis of sickle cell disease is confirmed by electrophoresis of hemoglobin in an alkaline medium and in an acid medium. It is a homozygous S / S sickle cell disease. The delivery was conducted under strict vagal supervision without complications. The association sickle cell and pregnancy is a risky situation, and the fortuitous discovery (our case) shows the interest of the biolologist both in the diagnosis and in the follow-up of the disease, hence the interest of close collaboration between clinician and biologist.