BACKGROUND Many studies have shown that pregnancy in sickle cell anaemia is associated with increased risk of maternal and foetal morbidity and mortality. There is little data on the maternal, foetal and perinatal outcomes of women with sickle cell anaemia in India. No such studies were conducted in Kerala. This study evaluated the various complications and outcomes of pregnancy in women with sickle cell anaemia (HbSS). MATERIALS AND METHODS We carried out a descriptive comparative study of

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... nant women in the age group of 15-40 years suffering from Sickle cell anaemia (HbSS) in Government Medical College, Kozhikode. Relevant past history, sickle cell related, obstetric and foetal complications were recorded. All the similar details of controls were collected from medical records. Complete blood count, peripheral smear and HPLC results of cases were analysed. Statistical analysis was done using standard analytical techniques with SPSS version 16.0 for Windows. Quantitative variables were expressed as mean while the qualitative variables were expressed as percentage. The difference and association between study variables were analysed using Chi-square test and p values <0.05 were considered significant. RESULTS A total of 70 women were included in the study. Women with sickle cell anaemia (HbSS) were cases (33). Tribal women without sickle cell anaemia were controls (37). All the cases had anaemia of different grades while only 56.75% had anaemia among controls. Increased frequency of sickle related complications were noted, especially vaso-occlusive crisis and haemolytic crisis. 87.87% of cases required blood transfusion. Statistically significant difference in obstetric and foetal complications were not found between cases and controls except for history of previous abortions. The association between HbF levels and occurrence of crisis was also statistically not significant. Neutrophilic leucocytosis was seen in patients with haemolytic crisis and vaso-occlusive crisis without any underlying infection. CONCLUSION This is the first study evaluating the effects of sickle cell anaemia on pregnancy in Kerala. Sickle cell related complications are more frequent during pregnancy. Unlike the previous studies statistical significance regarding obstetric and foetal complications were not found between cases and controls. Early and aggressive management by a multidisciplinary team of gynaecologists, haematologists and paediatricians can reduce the complications and bring good outcome to pregnancy in sickle cell anaemia.