• Milena Bastos Brito, Andrea Queiroz Vilas Boas, Anelise Maria Nicolau Silva, Flávia Pimentel Miranda, Carolina Brabec Barreto Matos, Oziemile Silva Santos, and Tais Paiva da Costa.
• Department of Gynecology and Obstetrics, Bahiana School of Medicine and Public Health (BSMPH), Salvador, Bahia, Brazil; Department of Gynecology and Obstetrics, Bahia Federal University (UFBA), Salvador, Bahia, Brazil. Electronic address: milenabrito@bahiana.edu.br.
• J Natl Med Assoc. 2024 Oct 19.

BackgroundSickle cell disease is a hereditary hemolytic anemia that exposes women to increased health risks especially in pregnancy, with serious implications for the woman and fetus. Acute pain episodes can occur multiple times per month and result in reduction of quality of life and disruption of her life.ObjectiveTo assess the clinical, including pain and metabolic parameters of women with sickle cell disease using etonogestrel-releasing contraceptive implants.MethodsWomen with sickle cell disease, aged 18-40 years, with reports of pain crises in the preceding 3 months were included and followed up for 12 months. Blood samples were collected to evaluate the blood count, reticulocytes, liver profile (alkaline phosphatase, gamma-glutamyl transferase, alanine aminotransferase, aspartate aminotransferase, and total bilirubin and its fractions), lipid profile, and lactate dehydrogenase levels before and 6 and 12 months after implant insertion. The following clinical variables were analyzed every 3 months: bleeding pattern, blood pressure, weight, body mass index, pain intensity (assessed using a visual analogic scale (VAS) from 0 to 10), and frequency of pain crises.ResultsTwenty-three women completed the study. There were no differences in laboratory variables between baseline and 6 and 12 months after implant insertion. Similarly, clinical variables did not differ, except for pain intensity (VAS pre-insertion = 8 vs. VAS 12 months post insertion = 4; p = 0.005) and frequency of pain crises (pre-insertion = 6 vs. 12 days/month post insertion = 0; p = 0.000).ConclusionsEtonogestrel-releasing contraceptive implants were associated with a reduction in the intensity and frequency of pain crises in women with sickle cell disease. Moreover, it was safety among these population due to no changes in laboratory parameters during the first 12 months of use.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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