Sickle Cell Disease and Hypertension

Doctor, can Pulmonary Hypertension in someone with Sickle cell disease be cured? I lost my last baby due to hypertension in pregnancy.

-Laraba

Generally, hypertension can be treated, but difficult to cure. In some cases when it has a definitive and treatable cause then it can be cured. Though it is difficult to cure hypertension, management on a general level is possible as long as the patient complies with the management and take drugs regularly with good follow up.

Concerning this case we have to distinguish whether hypertension started during pregnancy or before pregnancy and if it started during pregnancy did it get resolved after delivery? If hypertension started before your last pregnancy and persisted, then I will not advise you to get pregnant again, especially for someone with sickle cell disease.

If hypertension developed during the second half of your pregnancy and the blood pressure became normal after the delivery you can try another pregnancy. You have to see your physician and also an obstetrician prior to conception in what is called preconception care and ensure you register for antenatal as soon as you confirm the pregnancy

MENSTRUAL PERIODS

I am 26-years-old and started having serious menstrual pain after an evacuation I had in November last year. The pain usually starts a week to my menstrual period with fever and pains around my lower back and waist. I want to get pregnant again and I hope this will not be a hindrance in any way. How do I make this pain go away?

-Betty from Jos

The pains during menstrual period, otherwise called dysmenorrhea affect a large population of women of reproductive age. It could be primary or secondary. Primary when it occurs from the onset of menses while the ones that start later in life like yours, is secondary. Quite a number of causes are unknown.

Your case is secondary dysmenorrhea. In cases like yours, causes could include injury to the cervix and making it narrow or almost closed otherwise called cervical stenosis. Other factors like infection, adenomyosis and endometriosis can also be the cause.

The fact that you have dysmenorrhea does not mean you cannot get pregnant. For the pain you will need analgesics (pain killers). You need to consult a gynaecologist for proper examination, investigations and treatment.

PERSISTENT ABDOMINAL PAINS

I had terrible stomach pain recently and was taken to the hospital where a scan was done. The result showed nothing but the pain has persisted. Also, my stomach is swollen, I go to the toilet frequently and I am not pregnant. What do I do?

-Abigael, Kaduna

It is actually difficult for me to diagnose the problem based on the information provided above. Also, let me state that ultrasound is a complementary investigation not so definitive the fact that the scan says there was nothing detected does not mean all is well. What I will advise is that you see your family physician, further investigations and appropriate management.

Also, do not assume you are not pregnant. A blood test for pregnancy should be done. It is important with these kind of complaints – abdominal pains, abdominal swelling, going to the toilet often, and a woman of reproductive age, whether you missed your period or not: one must think of ectopic pregnancy. Kindly see your family physician as soon as possible.

Dr Nathaniel Adewole,
Mobile: 0803 8039182
EMAIL: [email protected]
Consultant Obstetrician & Gynaecologist
University of Abuja Teaching Hospital, Abuja