EC Gynaecology

Background: Hydroxyurea (HU) is contraindicated in pregnancy due to teratogenic risks [1]. We report two cases of inadvertent HU exposure during pregnancy in sickle cell anemia (SCA) patients, resulting in live births without congenital anomalies.

Cases: Two women with SCA continued HU until 18 and 36 weeks of gestation. Both developed severe oligohydramnios, necessitating cesarean delivery at 35-36 weeks. Birth weights were 2100g (Case 1) and 1988g (Case 2). At 6-month follow-up, both infants showed normal development and weight gain.

Conclusion: Despite HU exposure, both pregnancies yielded healthy infants. However, HU remains unsafe in pregnancy; rigorous contraception and preconception counseling are essential [1,2].

 Keywords: Hydroxyurea; Sickle Cell Anemia; Pregnancy; Oligohydramnios; Teratogenicity; Preterm Birth

1. Singh SA., et al. “Hydroxyurea use during pregnancy: A systematic review and meta-analysis”. American Journal of Hematology6 (2021): E204-E207.
2. Berard R., et al. “Neurodevelopmental outcome of children exposed to hydroxyurea in utero”. European Journal of Haematology 2 (2020): 136-144.
3. Ballas SK., et al. “The effect of hydroxyurea on pregnancy and sperm parameters in sickle cell disease: A comprehensive review”. Transfusion2 (2019): 719-729.
4. Siklos^® (hydroxyurea) Tablets Prescribing Information. US FDA (2021).