| ID | 335 |
|---|---|
| Name | ANEMIA IN PREGNANCY |
| Cause | Causes: 1. Physiological - In pregnancy blood volume increases 15-20%, plasma volume increase 30%. 2. Pathological- anorexia, nausea, vomiting. ‘ 3. Increased metabolic demand- 350mg for foetus. if f 350mg for mother. 100mg for placenta. 100mg of iron is saved due to ceasation of menstruation. So excess demand is 700mg/day. 4. Blood loss- in APH, bleeding piles, hook worms infestation. |
| Signs Symptoms | Pale skin, lips, and nails. Feeling tired or weak. Dizziness. Shortness of breath |
| Diagnosis | A serum ferritin concentration <30 μg/L together with an Hb concentration <11 g/dL during the 1st trimester, <10.5 g/dL during the 2nd trimester, and <11 g/dL during the 3rd trimester are diagnostic for anemia during pregnancy |
| Investigations | Investigations: findings- 1. R.B.C count, Hb%, MCHC, serum iron- all are low. 2. There may be anisocytosis, poikilocytosis, microcytosis & increased reticulocyte count. |
| Management | Mild to moderate anemia: Daily prenatal vitamin or iron supplement. This gives body healthy amounts of iron, vitamin B12 and folic acid. Severe anemia: Need a blood transfusion |
| Introduction | The commonest type of anemia during pregnancy is that due to iron deficiency. Iron deficiency may develop as a result of a poor diet, or the patient failing to take the tablets which are prescribed for her and also may develop from hook-worm infestation. * In severe cases the patient may look pale and she may have noticed tiredness, breathlessness, palpitation or fainting. |
| History | |
| Etiology | see under cause |
| Clinical Features | see under sign and symptoms |
| Preventions | Diet rich in iron, vitamin C and B vitamins |
| Treatment | Treatment: Depends on severity of anemia & duration of pregnancy. A. Early pregnancy with moderate anemia- 1. Tab. ferrous fumerate 200 mg t.d.s till Hb% 10 gm/dl. This improve Hb% Igm per dl per month. 2. If no response occur or having Iron intoler-ance then parenteral iron therapy should be given-Iron dextran or Iron sorbiol 2ml ‘i.m daily till Hb% 10 gm/dl. Or Total dose of iron dextran in i.v drip (250mg of iron dextran raise Hb. 1 gm/dl in 1000 c.c of normal saline slowly). B. Late pregnancy (30-36) weeks- Parenteral iron to be given as oral iron in that case has slow response. C Severe anemia near delivery (after 36 seek). -Fresh blood or packed cell infusion. (One pint of blood raises Hb level 0.7 gm/dl). |
| Complications | Increased morbidity and fetal death. Affected mothers frequently experience breathing difficulties, fainting, tiredness, palpitations, and sleep difficulties |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
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