This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Physiological changes during Pregnancy, Subject name: Gynaecology & Obstetrics
Blood transfusion is indicated in following conditions associated with sickle cell anemia: 
Select and explain. 
A. Frequent sickling episodes, B. Twin pregnancy, C. Poor obstetrical outcome, D. All of the above
D: All of the above
Answer: D: All of the above 
Explanation: Ans. is d, i.e. All of the aboveRef. Fernando Arias 4/e, p 238Prophylactic blood transfusions are not routinely advocated in all pregnant females with sickle cell anemia.Indications:1. Frequent severe sickling episodes.2. Low hematocrit levels.3. Twin pregnancy.4. Poor past obstetrical history.Target: HbS levels becomes <20%.