ABSTRACT
The stress of labour may precipitate a sickle cell crisis. As a general rule patients with sickle cell disease should only be transfused because of a particular clinical situation, not just because they have sickle cell disease. Such situations might be their obstetric or haematological history, or clinical problems in a current pregnancy. The final decision on transfusion will normally be made together by the consultant obstetrician and haematologist. Possible indications include an ongoing high transfusion regime, multiple pregnancy, poor fetal growth or a haemoglobin 15% less than the steady state level. For all these reasons it is essential that: the request form for transfusion be clearly marked indicating that the patient has sickle cell disease and that the transfusion laboratory be given as much notice as possible that a transfusion is required (often at least 3 working days) unless the transfusion is required as a medical emergency.
