Successful Management of Sickle Cell Crisis and High-Risk Pregnancy: A Case of 27-Year-Old Female in Active Labor

A 27 years old female had 8 months of pregnancy. She developed severe bodyache mainly leg, upper limb and chest pain. She was sickling positive. She was examined and treated by ideal gynecologist. He diagnosed that patient was in sickle cell crisis, but not in active labor. It was referred to sterling hospital for management of sickle cell crisis. It came to us and we gave her intravenous fluid, sodabicarb, folic acid, magnesium and intravenous antibiotics, Gynec reference done she found that patient was in active labor but she advised to give by betnesol for foetal lung maturity. She was treated for severe painful vasocclusive crisis, Hematologist opinion was taken and hb electrophoresis was sent, which reveled 70% hbs. She had ongoing crisis, it was thought and continuation of pregnancy may lead to foetal loss So elective LSCS was done, live foctus delivered. foetus aspirated meanium so needed to be kept in MICU for 4.5 days. After LSCS it. threw generalized tonic clonic seizures. It was given by levetiracetam and managed in cell. This seizures were due to vasocclusion in brain. Now it was started on exchange transfusion were 1-2 units of fresh non-sickling was transfused and its blood was removed. After 3-4 exchange its hbs was repeated which was 30% new pain was reduced and it was fully conscious with no further seizures. It was also started on hydroxyurea. It was allowed breastfeeding. As hydroxyurea is secreted milk, 5 hrs gap was kept for breastfeed after hydroxyurea dosage, Now patient was better and new born was also well, both saved successfully with a good team work and discharged from hospital.

The choice of a leadless pacemaker in this case was crucial to the patient's recovery. Leadless pacemakers offer several advantages, including a lower risk of infection, absence of leads that could be displaced due to involuntary movements, and quicker recovery time.