Outcomes of procedures for abortions and early pregnancy loss among people with sickle cell disease: A single-center experience

People with sickle cell disease (SCD) have an increased risk of pregnancy loss and severe maternal morbidity in pregnancy yet there is little data on the outcomes of abortions or pregnancy loss among these individuals. This retrospective review aimed to describe the clinical outcomes of procedurally managed abortions and early pregnancy losses among individuals with sickle cell disease at a single center. We identified 19 individuals with sickle cell disease who underwent 24 procedures for the management of abortion (n = 18) or pregnancy loss (n = 6) at our center from 2013 to 2022. There were few procedure-related complications. Most of the post-procedural complications were painful crises. Individuals with a high frequency of painful crises before the procedure had a 1.2 higher odds of experiencing post-procedural painful crises (95 % CI: 1.0–1.4). Individuals with higher baseline rates of painful crises were more likely to develop post-procedural pain crises. This study is the first since 1995 to report on abortion and pregnancy loss outcomes in SCD. As threats to accessing reproductive health care continue to grow in the U.S., we must refine practice models to deliver safe care to patients with SCD who seek reproductive health services.