{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:10:16Z","timestamp":1777864216240,"version":"3.51.4"},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AJP Rep"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Sickle cell disease (SCD) in pregnancy is associated with substantially increased risks of stillbirth and neonatal death due to vaso-occlusive crises, chronic anemia, and impaired placental perfusion.<\/jats:p>\n                  <jats:p>Case We present the case of a 25-year-old primigravida with HbSS disease who presented at 29 weeks\u2019 gestation with a vaso-occlusive pain crisis. Although she was initially clinically stable with reassuring fetal testing, she developed acute fetal distress on hospital day 3, prompting an emergent cesarean delivery. Intraoperatively, the uterus appeared profoundly hypoperfused with minimal bleeding despite uterine atony. The neonate was delivered in asystole and required prolonged resuscitation. Postresuscitation examination raised concern for severe hypoxic ischemic encephalopathy, and the parents elected to transition to comfort care. The neonate died shortly after withdrawal of life-sustaining interventions. Placental pathology demonstrated prominent sickled erythrocytes and increased fetal nucleated red blood cells, consistent with prolonged impaired oxygen delivery.<\/jats:p>\n                  <jats:p>Conclusion This case highlights the unpredictable and acute nature of fetal compromise in pregnancies complicated by SCD, which may occur prior to guideline-recommended antenatal surveillance. Although prophylactic transfusion remains controversial, emerging evidence suggests a potential benefit in selecting high-risk patients. Early multidisciplinary management, individualized transfusion strategies, and heightened vigilance for sudden fetal decompensation are essential to improving perinatal outcomes in SCD.<\/jats:p>","DOI":"10.1055\/a-2849-8204","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T23:04:42Z","timestamp":1776121482000},"page":"e96-e100","source":"Crossref","is-referenced-by-count":0,"title":["Sickle Cell Vaso-Occlusive Crisis Leading to Uteroplacental Malperfusion: A Case Report"],"prefix":"10.1055","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5484-2591","authenticated-orcid":false,"given":"Annika","family":"van Oosbree","sequence":"additional","affiliation":[{"name":"Department of Obstetrics\/Gynecology, Medical University of South Carolina, Charleston, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gretchen","family":"Hahn","sequence":"additional","affiliation":[{"name":"Department of Obstetrics\/Gynecology, Medical University of South Carolina, Charleston, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Shea","sequence":"additional","affiliation":[{"name":"Department of Obstetrics\/Gynecology, Medical University of South Carolina, Charleston, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"issue":"21","key":"ref1","doi-asserted-by":"crossref","first-page":"3316","DOI":"10.1182\/blood-2014-11-607317","article-title":"Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis","volume":"125","author":"E Oteng-Ntim","year":"2015","journal-title":"Blood"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1080\/14767058.2020.1743657","article-title":"Outcome of pregnancies among women with sickle cell disease","volume":"35","author":"E Nkwabong","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/1471-0528.13786","article-title":"Pregnancy outcomes in women with sickle-cell disease in low and high income countries: a\u2009systematic review and meta-analysis","volume":"123","author":"T K Boafor","year":"2016","journal-title":"BJOG"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"505.e1","DOI":"10.1016\/j.ajog.2016.05.032","article-title":"Contemporary outcomes of sickle cell disease in pregnancy","volume":"215","author":"K Kuo","year":"2016","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref5","first-page":"419","article-title":"Pregnancy and sickle cell hemoglobinopathies: results with and without prophylactic transfusions","volume":"62","author":"F G Cunningham","year":"1983","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref6","first-page":"28","article-title":"Pregnancy in the sickle hemoglobinopathies","volume":"11","author":"E Z Fiakpui","year":"1973","journal-title":"J Reprod Med"},{"issue":"22","key":"ref7","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1056\/NEJM198812013192204","article-title":"Prophylactic red-cell transfusions in pregnant patients with sickle cell disease. A randomized cooperative study","volume":"319","author":"M Koshy","year":"1988","journal-title":"N Engl J Med"},{"issue":"21","key":"ref8","doi-asserted-by":"crossref","first-page":"2424","DOI":"10.1182\/blood-2015-06-649319","article-title":"Prophylactic transfusion for pregnant women with sickle cell disease: a systematic review and meta-analysis","volume":"126","author":"A K Malinowski","year":"2015","journal-title":"Blood"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"e21086","DOI":"10.1002\/jha2.1086","article-title":"Prophylactic versus on-demand transfusion in pregnant women with sickle cell disease: a systematic review and meta-analysis of randomised controlled trials","volume":"6","author":"D M Brunetta","year":"2025","journal-title":"eJHaem"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1182\/bloodadvances.2019001143","article-title":"American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support","volume":"4","author":"S T Chou","year":"2020","journal-title":"Blood Adv"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"B17","DOI":"10.1016\/j.ajog.2023.10.031","article-title":"Society for Maternal-Fetal Medicine; Society for Maternal-Fetal Medicine Publications Committee. Electronic address: pubs@smfm.Org. Society for Maternal-Fetal Medicine consult series #68: sickle cell disease in pregnancy","volume":"230","author":"R G Sinkey","year":"2024","journal-title":"Am J Obstet Gynecol"}],"container-title":["American Journal of Perinatology Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2849-8204.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:38:25Z","timestamp":1777527505000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2849-8204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":11,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2026,4,7]]},"published-print":{"date-parts":[[2026,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2849-8204","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2157-6998","2157-7005"],"issn-type":[{"value":"2157-6998","type":"print"},{"value":"2157-7005","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4,13]]},"published":{"date-parts":[[2026,4]]}}}