This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
Blood transfusion is indicated in the following condition with sickle cell anaemia 
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: Indications of Blood transfusion in Sickle Cell Anemia

Frequent sickling episodes
Twin pregnancy
Poor obstetrical outcome
Severe anaemia

Blood transfusion replaces the abnormal cells with normal red cells
The objective of transfusion is to keep the hematocrit value above 25% and concentration of Hb–Sunder 50% 
Prophylactic transfusions during pregnancy remain controversial