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Anaemia in Pregnancy
Obstetrics 

Anaemia can be defined as a low count of red blood cells. It is a common condition during pregnancy secondary to a combination of dilution as fluid is retained and negative iron balance. Pregnant women should be evaluated carefully for anaemia during the first trimester and at around 28 weeks. The most common cause of anaemia during pregnancy is iron deficiency. Some women have low iron levels early in their pregnancy because of blood loss through their monthly periods.

 

Symptoms and signs of Anaemia.

 

The most common sign and symptoms are the following: paleness, weakness, feeling unusually tired, fatiguing easily, feeling irritable, difficult breathing, fainting, headache.   

 

Diagnosis

 

The diagnosis of Anaemia is made taking into consideration the symptoms related by the woman as well as the signs observed on physical examination and usually, it is confirmed by blood testing. These investigations are done with the objective to identify the degree, type, and origin of the anaemia.

 

Management of anaemia in Pregnancy

 

The management of anaemia during pregnancy may include different approaches.

 

  1. Prophylactic

The prevention of anaemia during pregnancy is aided by a diet rich in vitamins and minerals. A practical and balanced diet rich in iron and portion like liver, meat, eggs, green vegetable, is very important.

 

  1. Treatment

Iron supplements. Ferrous Sulphate is generally ordered for pregnant women elevated the risk of anaemia.

Folic acid supplements may be indicated combined with iron (ferrous) supplements.

Vitamin B12 is sometimes needed.

Vitamin C supplements are also recommended to aid iron absorption.

Increasing dietary iron intake. Red meat is excellent, with white meat providing a sound alternative. Non-haem iron is present in green leafy vegetables, such as broccoli, silverbeet, and beans.

 

The need for more specific iron therapy such as parenteral (through an intravenous infusion) iron or blood transfusion will depend on the severity of anaemia, duration of pregnancy, and other complicating factors

 

Complications of severe anaemia:

 

Different studies have shown the impact of anaemia during pregnancy such as Pre-eclampsia, Recurrent infection, Heart failure, and preterm labour. During the labour process, the anaemia has been related to uterine inertia, postpartum haemorrhage, cardiac failure, and hypovolemic shock. During the puerperium, the presence of anaemia is linked with puerperal sepsis, uterine sub-involution, and failing lactation.

 

Prognosis

 

With proper treatment, the iron level should respond to within a normal range in four weeks. Even after delivery, iron supplementation is usually recommended to compensate for extra blood loss at the time of birth. Follow-up blood tests are generally indicated at the six-week postnatal check.

 

You can make an appointment with Dr Kenny on 07 3188 5000.

This article is written to be informative and does not substitute seeking a professional consultation from a medical professional.

 

References

  1. UK Guideline on the management of iron deficiency in pregnancy. Br J Haematol.Mar 2012.
  2. Sue Pavord, Susan Robinson, Bethan Myers, Christina Oppenheimer. Prepartum anaemia: Prevention and treatment.Dec 2008.Ann Hematol
  3. Nils Milman. Expert recommendations for the diagnosis and treatment of iron-deficiency anemia during pregnancy and the postpartum period in the Asia-Pacific region. Nov 2010. J Perinat Med
  4. Xu-Ming Bian, Lourdes R Blanco-Capito, Rakhshanda Rehman, Christian Breymann. Diagnosis and management of iron deficiency anaemia: A clinical update. Nov 2010, MED J AUSTRALIA.
  5. Kathryn L Robinson,  Steve Flecknoe-Brown, Sant-Rayn Pasricha, Katrina J Allen. ACOG Practice Bulletin NO. 56. American College of Obstetricians and Gynecologists. May 2010. Am J Obstet Gynecol
  6. Roger K. Freeman, Michael P Nageotte. Iron and pregnancy – A delicate balance. Oct 2006.ANN HEMATOL
  7. Bryant C, larsen S. Anaemia in pregnancy. The Australian and New Zealand Journal of Obstetrics and Gynaecology. 2009;11:17
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