Multidisciplinary Care Team Greatly Reduces Risk in Pregnant SCD Patients in Low-income Countries
According to a study published in the American Journal of Hematology, the presence of a multidisciplinary clinical team can dramatically reduce maternal and perinatal mortality rates in pregnant women with sickle cell disease (SCD), especially in under-developed and low-income countries.
In recent decades, medical advances have significantly improved the survival of those living with SCD, which now raises a new health challenge. Pregnant women with sickle cell disease have increased risks of complications and a higher risk of mortality.
This is of particular concern in sub-Saharan Africa, where SCD is considered a public health problem and the maternal mortality rate in women with the disease ranges from 7 to 12 percent.
Previous studies have demonstrated that pregnant women with SCD in low- and middle-income countries have about a 23 times higher risk of maternal mortality compared to those without SCD in the same financial status.
But this negative effect was not observed in higher-income societies, suggesting that improved medical support can have a great impact on maternal mortality in SCD patients.
To address this, researchers from Ghana assessed the maternal and prenatal outcomes of pregnant women with SCD before and after a multidisciplinary care team was implemented. The team, consisting of obstetricians, hematologists, a pediatrician, nurses, and a clinician trained in pulmonology, addressed the immediate needs of pregnant sickle cell patients to anticipate strategies for any medical need.
According to the study, “Implementation of Multi-Disciplinary Care Reduces Maternal Mortality in Women with Sickle Cell Disease Living in Low-resource Setting,” the presence of a multidisciplinary care team improved the maternal mortality rate by 89.1 percent and reduced the risk of perinatal mortality by 62.2 percent.
“We have demonstrated that a multidisciplinary care team consisting of hematologists, pediatrician, and obstetricians, applying simple, reproducible and inexpensive standard care protocols, in the care of pregnant women with SCD significantly decreases maternal and perinatal mortality in a low-resource setting,” the researchers wrote.
Despite the positive results reported in this study, additional strategies should be employed to improve the outcome rates of these patients to those seen in people without the disease and those in higher-income countries.