Conclusions
The AGREE II assessment of the four included SCD in pregnancy CPGs revealed methodological shortcomings in several domains. We recommend several areas for improvement for future CPGs, using the AGREE II criteria and the RCOG and NICE CPGs as models. The NICE 2016, RCOG 2018, followed by the NHLBI 2014 CPGs, showed the highest quality and were strongly recommended in the present evaluation. This critical appraisal highlights the importance of quality assessment of CPGs by clinicians to ensure the transparency and strength of the CPG development process according to international CPG standards and to support the provision of best practice for pregnant women with SCD. We recommend incorporating the AGREE II appraisal of CPGs in the capacity building of Obstetricians and Gynecologists and Hematologists.