A 26-year-old woman with sickle cell disease (HbSS) on regular hydroxyurea attends preconception counselling. She asks about continuing her medications. Which statement is CORRECT?

• A Hydroxyurea should be stopped at least 3 months before attempting conception ✓
• B Hydroxyurea is safe throughout pregnancy and should be continued
• C Hydroxyurea should be switched to deferiprone during pregnancy
• D Hydroxyurea may be continued until the anomaly scan at 20 weeks

Explanation

Hydroxyurea is teratogenic in animal studies and is cytotoxic, so standard practice is to discontinue it at least 3 months before conception and substitute folic acid supplementation, with transfusion support reserved for severe maternal complications. It is not continued through pregnancy or merely until the anomaly scan. Deferiprone is an oral chelator used in iron overload states such as thalassaemia, not an alternative sickle-modifying agent, and is itself avoided in pregnancy.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.