SCREENING: Genetic and support counseling are essential for couples at risk or with SCD in their families. In some areas all babies are screened for hemoglobin abnormalities regardless of ethnic origin. Early detection means the condition can be managed properly, and in particular that treatment with penicillin can begin promptly to minimize the risk of lung infections.
Prenatal screening is available to find out if a baby’s hemoglobin is normal and can be carried out at the time of amniocentesis (usually about 16 weeks into the pregnancy). Screening is advisable for pregnant women who are aware that they have sickle cell trait. Couples will be offered counseling to clarify the risks of having a baby.
TREATMENT: A child who has SCD will need frequent doses of penicillin to nip bacterial infections in the bud. This should be given from the time of diagnoses until the child is at least eight years of age, and usually until after adolescence. A child who suffers from chronic anemia will need folic acid supplements. He should drink plenty of fluids to prevent dehydration – at least one quart (1 liter) daily – and should always keep warm, to encourage normal circulation. Although overexertion can cause problems, the child should exercise and find his own energy tolerance level – exercise will improve the health of his heart and circulation. Pain and symptoms of infection should be treated promptly.
When millions of red blood cells have been destroyed, exchange transfusion in hospital will be necessary. Sometimes many exchange transfusions will have to be given. Although this is a lengthy procedure, it is well worthwhile since it will allow the child to lead a near-normal life.
