WHO Releases New Guidelines for Managing Pregnant Women with Sickle Cell
In a major move to improve maternal and neonatal health outcomes, the World Health Organization (WHO) has released new clinical guidelines for the care and management of pregnant women living with sickle cell disease (SCD).
The guidelines, unveiled this week, are designed to assist healthcare providers in offering safer, more effective treatment for a vulnerable population often overlooked in global health systems.
Sickle cell disease, a genetic blood disorder that alters the shape of red blood cells, poses severe complications during pregnancy — including increased risks of maternal mortality, fetal loss, infections, and preeclampsia.
The WHO noted that in some parts of the world, maternal deaths among women with SCD are up to 26 times higher than in the general population.
“Pregnancy in women with sickle cell disease presents significant clinical challenges,” the WHO said in a statement. “These new guidelines aim to reduce avoidable suffering and death through early intervention, comprehensive monitoring, and integrated care.”
The new WHO framework outlines several critical areas of focus:
1. Multidisciplinary and Specialized Care
The guidelines emphasize that pregnant women with SCD should be managed by a multidisciplinary team, including obstetricians, hematologists, nurses, anesthesiologists, and mental health professionals.
This integrated approach ensures early detection of complications and coordinated emergency response when needed.
2. Comprehensive Antenatal Monitoring
Women are advised to begin routine antenatal visits every 4 weeks until 24 weeks gestation, then more frequently — every 1 to 2 weeks — until delivery. Ultrasound scans to monitor fetal growth should begin at 28 weeks and repeat every 4 weeks. In high-risk cases, antenatal fetal testing may begin at 32 weeks.
3. Vaccinations and Nutritional Support
Due to heightened infection risks, pregnant women with SCD should receive routine immunizations, including pneumococcal and meningococcal vaccines. Nutritional support is also essential, with the WHO recommending high-dose folic acid (4–5 mg daily) and prenatal vitamins. Iron supplementation should only be prescribed if iron deficiency is confirmed, as excess iron can be harmful in SCD patients.
4. Pain Management and Thromboprophylaxis
Pain crises during pregnancy must be managed with care. The WHO encourages the use of evidence-based pain relief protocols that are safe for both mother and fetus. In cases with heightened risk for blood clots, the guidelines recommend low-dose aspirin or heparin, depending on the severity of the case.
5. Blood Transfusion Protocols
While routine transfusions are not recommended for all, the WHO advises that selective transfusion therapy — including simple or exchange transfusions — may be necessary in cases of severe anemia, acute chest syndrome, or preeclampsia.
6. Pre-Pregnancy Counseling and Family Planning
The WHO urges health systems to offer pre-conception counseling, discussing the risks associated with SCD in pregnancy, available treatment options, genetic transmission to offspring, and the safe use of disease-modifying drugs like hydroxyurea.
The release of these guidelines comes amid a broader push to improve care for people with sickle cell disease, especially in sub-Saharan Africa and South Asia, where the condition is most prevalent. In 2024, WHO launched the SICKLE Package, a public health initiative aimed at expanding early diagnosis, promoting hydroxyurea use, and improving access to care across low- and middle-income countries.
By providing actionable, evidence-based strategies, WHO hopes to support national governments in integrating these protocols into public health systems, especially in areas where maternal and newborn mortality rates remain high.
“This is a major step forward,” said Dr. Henrietta Gyang, a maternal health consultant. “These guidelines will not only save lives, but also help normalize access to quality care for women with sickle cell disease.”
Countries are now encouraged to localize and implement the guidelines through national health agencies, medical training programs, and hospital protocols. With proper funding, awareness, and political will, WHO believes these measures can significantly reduce maternal and neonatal deaths related to SCD.
As healthcare systems begin to adopt the new standards, the organization plans to monitor global progress, collect implementation data, and update its recommendations as new research emerges.
The WHO’s newly released guidelines represent a critical turning point in global reproductive and maternal health. With focused action, the vision of safer pregnancies and healthier futures for women living with sickle cell disease is now within reach.
