Bibliographic information
GuidelineWHO recommendations on the management of sickle cell disease during pregnancy, childbirth and the interpregnancy period
Year of Publication2025
Issuing InstitutionWorld Health Organization
Recommendation
New
Collaborate with pregnant women with sickle-cell disease (SCD) to develop individualized pain-management plans as early in pregnancy as possible, basing the plan on severity and frequency of pain crises, and the woman’s views and preferences, and including a multidisciplinary team approach to care.
Recommended
Notes and Remarks
Pain-management plans in the non-pregnant SCD population
- Outside of pregnancy, individualized pain-management plans have been shown to reduce length of hospital stay, frequency of admissions/readmissions and time to first opioid dose in the emergency department (157, 158, 159). Aims of pain management plans
- A pain-management plan is a comprehensive and individualized approach with a goal to avoid painful crises, mitigate pain, enhance quality of life, or address other aspects associated with the pain experience. Pain-management plans may address different aspects of the treatment of sickle-cell pain, including supportive, symptomatic, preventative and abortive management (160). Individualization of components of a pain-management plan
- A pain-management plan can support self-care strategies (based on awareness of precipitating factors such as dehydration, change in altitude, extremes in temperature, infections and physical and psychological stress), as well as providing guidance to health-care providers to support timely interventions responsive to the needs of the individual woman taking into consideration the woman’s knowledge of effective pain medications and doses, and past experience with side-effects.
- To be effective, a plan needs to be actionable for the individual woman given her living situation and available resources, while meeting her clinical needs.