Ethical and Clinical Considerations in the Use of Hydroxyurea in Pregnant Women with Sickle Cell Disease.

This letter to the editor discusses the ethical and clinical considerations of using hydroxyurea (HU) in pregnant women with sickle cell disease (SCD). Pregnant women with SCD face increased risks of adverse maternal, fetal, and neonatal outcomes, including maternal death, intrauterine growth restriction, stillbirth, anemia, low birth weight, and preeclampsia/eclampsia. HU is currently not recommended during pregnancy due to concerns about fetal malformations, but case series and cohort studies have reported no increased risk of malformations. The authors argue for the need for rigorous studies to evaluate the effectiveness and risks of using HU in pregnant women with SCD, including a randomized control trial. [Extracted from the article]