Anemia in Pregnancy

Anemia in Pregnancy
 Anemia is a medical condition in which

there is not enough healthy red blood cells
to carry oxygen to the tissues in the body.
 When the tissues do not receive an
adequate amount of oxygen, many organs
and functions are affected. Anemia during
pregnancy is especially a concern because
it is associated with low birth weight,
premature birth and maternal mortality.
 It is diagnosed anemia if the hemoglobin
concentration is under:
11 g/dL  1st trimester
10,5 g/dL  2nd trimester
11 g/dL  3rd trimester
 And the hematocrite concentration is
under:
33 %  1st trimester
32 %  2nd trimester
33 %  3rd trimester
 It's normal to have mild anemia when
you are pregnant. But you may have
more severe anemia from low iron or
vitamin levels or from other reasons.
 Anemia can leave you feeling tired,
weak and your skin will looks more pale.
 The most commonly experienced types
of anemia during pregnancy are:
-iron deficiency anemia
-folate deficiency anemia
-vitamin b12 deficiency anemia
Iron-deficiency Anemia
 This is the most common cause of anemia in

pregnancy
Pathophysiology
 Inadequate oral iron intake, so the body doesn’t
have enough iron to produce adequate amounts of
hemoglobin
 the loss of iron stores because of increased
maternal blood production and fetal growth needs.
-Pregnancy requires an increase to 15 to 18 mg
per day of elemental iron
-In total, pregnancy requires about 1130 mg of
elemental iron
 450 mg for RBC expansion
 360 mg for fetus-placenta
 170 mg for basal loss
 150 mg for delivery loss.
 Bleeding during pregnancy, vaginally or from
another source
 Multiple gestation
 Iron malabsorption
 Concurrent antacid use, which may prevent
iron absorption
 Poor dietary habits or pica (an appetite for
inedible substances, such as clay or dirt).
Evaluation
 Ask about patient’s history
 The symptoms are nonspecific and diagnosis
depends on laboratory evaluation.
 Laboratory test
 Low serum iron, low serum feritin, high total
iron binding capacity (TIBC), low MCV and
MCH
Treatment
 Ferrous sulfate, 300 mg tablets, contain
60 mg (10 grains) of elemental iron.
1x1tablets / day
 Intestinal absorption permits absorption
only up to 15 mg of iron without signs of
iron intolerance or even toxicity.
Anemia Resulting from Folic Acid
Deficiency
 Folic acid deficiency is the second common

anemia in pregnancy.
Pathophysiology
 the recommended daily requirement for folic acid is 0.4
mg; this increases to 0.8 to 1.0 mg during pregnancy.
 There are folic transfer from mother to fetus
 Folate stores are limited and easily depleted within a
few months in times of increased demand
 All supplies of folate must come from external sources:
Prime dietary sources are fruits and vegetables, of
which the best are
 Spinach
 Lettuce
 Asparagus
 Broccoli
 Lima beans
 Melons
 Bananas.
Etiology
 pregnant women may be at risk , those with
the following:
 Ongoing hemolysis
 Seizure disorders on medication interfering with
folic acid metabolism
 Multiple gestation.
Epidemiology
 Folic acid deficiency is the most common
cause of megaloblastic anemia.
Evaluation
 The symptoms are similar to other anemia
symptoms
 Deficiencies in either folic acid or B12 can
present with glossitis and roughness of skin.
 Laboratory test
 Normal MCH and MCHC, but high MCV
 Low serum folate (less than 3 ng/ml)
 This may contribute to birth defects, such as neural
tube abnormalities, and could lead to preterm labor
 And also associated with such pregnancy

complications
 Low birth weight
 Smaller maternal blood volume
 Abruptio placentae
 Prematurity.
Treatment
 Medications
-The daily dose of folic acid is 0,4 mg/day
-an increased reticulocyte count should be seen
within three to four days.
-If neurologic symptoms are present, a B12 level
should be measured because folic acid will
correct the anemia but not the neurologic sympt
-Oral folic acid is sufficient for treatment unless
folic acid antagonists are being used, at which
time parenteral folic acid is indicated.
Anemia from B12 Deficiency
Etiology
 B12 is absorbed in the ileum, bound to
intrinsic factor.
 B12 deficiency is rarely due to inadequate
ingestion, except in strict vegetarians.
 malabsorption syndromes are common
causes.
○ Pernicious anemia (rare in this age group)
○ Previous gastric or intestinal surgery
○ Inflammatory bowel disease
○ Helminth infestations.
Evaluation
 Laboratory Tests
necessary to establish the diagnosis.
 A radioimmunoassay is used to measure B12
serum levels.
 levels below 50 pg per ml are indicative of B12
deficiency.
 The Schilling test is used to measure B12
absorption but is contraindicated in pregnancy
because of the use of radioactive cobalt.
 Neurologic abnormalities are seen, as are
elevated serum bilirubin and lactic
dehydrogenase levels (4).
Diagnosis
 Clinical Manifestations
 Neurologic symptoms
Treatment
 Medications
1 mg B12 is given parenterally weekly5-6
weeks, then 100 mcg monthly.
 should respond within six weeks.
 A brisk reticulocytosis should manifest within
3-5 days.
Thank You

Anemia in Pregnancy

Uploaded by

Copyright:

Available Formats

Anemia in Pregnancy

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Anemia in Pregnancy

Uploaded by

Copyright:

Available Formats

Anemia in Pregnancy

 Anemia is a medical condition in which

 This is the most common cause of anemia in

 Folic acid deficiency is the second common

 And also associated with such pregnancy

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.