Prevention Contraception is controversial in sickle syndromes, however, there is no compelling evidence which precludes the use of any available method. The combination of a condom and spermicidal foam provides safe, effective contraception and may reduce the transmission of AIDS and other sexually transmitted diseases. Oral contraception is probably the most effective and is probably safe if low-dose estrogen preparations are used. The IUD is also effective. Diaphragms are usually less effective, however, may be satisfactory if combined with a spermicidal preparation.
Progesterone based prevention by pill or depo preparations is also effective.
Fathers should always be tested and the risk of having an affected child determined. It is very important to do both a CBC with indices and hemoglobin electrophoresis to detect structural hemoglobin variants and thalassemias. Non-directive counseling should be provided with information about prenatal diagnosis. Termination of pregnancy is accomplished by suction curettage in the first thirteen weeks. Hypertonic urea with prostaglandin F2 is safe in later pregnancies.