SIGNS OF PREGNANCY ANEMIA WHICH YOU MUST KNOW.

            Anemia is a lack of functioning red blood cells (RBCs) that leads to a lack of oxygen-carrying ability, causing unusual complications during life time1,OR is the reduction in the quantity of the oxygen-carrying pigment i.e. haemoglobin in the blood.

            According to the recent standard laid down by ‘WHO’, anemia is present when the Hemoglobin (Hb) concentration in the peripheral blood is 11 gm./dl or less, or the hematocrit equivalent of less than 0.33.

The reason is that as the pregnancy progresses, the blood is diluted and the woman will eventually become anemic.

                During pregnancy, late arrival for treatment is common, with large numbers of those affected being seen for the first time with severe degrees of anemia

 

MAJOR CAUSES OF ANEMIA DURING PREGNANCY.

• The most common cause of anemia in pregnancy is lack of iron. Less often, it is caused by folic acid deficiency.

• Those most at risk are women from low socio-economic groups and teenagers.

•  Iron and folate supplementation is indicated during pregnancy to prevent the complications.

• In developing countries, the principal causes of anaemia in pregnancy are nutritional deficiencies of iron and folic acid and malaria (chiefly Plasmodium falciparum).

• Chronic disorders which present with anemia include AIDS, sickle-cell disease, thalassemia’s and hook-worm and schitosoma infestation. 

• Anaemia may also feature in chronic renal and hepatic disease due to the metabolic disturbances they cause.

 

TYPES OF ANEMIA WHICH CAN OCCUR DURING PREGNANCY.

                            (A) Physiological anemia in pregnancy.

                             (B) Pathological anemia in pregnancy.

 

(A) Physiological anemia in pregnancy.

 

During pregnancy there is disproportionate increase in plasma volume up to 50% (1000mls), RBC 33% (approximately 300mg) as a result of the increase in the production of erythropoietin.

In addition there is marked demand of extra iron during pregnancy especially in the second half of pregnancy. So, physiological anemia is due to combined effect of hemodialution & negative iron balance

                             

  (B) Pathological anemia in pregnancy.

Pathological Anemia is further sub-classified into:

§  Deficiency Anemia

               -Iron deficiency

               -Folic acid deficiency and

               -B12 deficiency

§  Hemorrigic

    Acute hemorrhagic- bleeding in early month of pregnancy or APH or

    Chronic hemorrhagic: as by hookworm infestation, GI (gastrointestinal) bleeding

•      Anemia can be also classified according to severity as mild, moderate, severe and very severe.

The need for blood transfusions or not will depend on the severity as well as rapidity of development of anemia

When you are pregnant you should know these values and what they indicate inorder to increase your diet iniron intake

Mild Anemia -10-10.9g/dl

Moderate-7-9.9g/dl

Severe -4-6.9d/dl

Very severe -   <4g/dl

 

RISK FACTORS FOR ANAEMIA IN PREGNANCY

§  Physiological changes in pregnancy

•      Increase in maternal blood volume     

• Demands for iron of thegrowing fetus and placenta

•  Growth spurt during adolescence leading to increase needs for iron

§  Too soon & too many pregnancies result in higher prevalence of iron deficiency anemia, because iron storage are depleted with each pregnancy.

§  Regular menstrual loss

§  Other factors:

–     Poor diet

–     Frequent parasitic infections

THE FOLLOWINGS ARE THE SIGNS AND SYMTOMS THAT SHOWS YOU HAVE ANAEMIA DURING PREGNANCY.

• Impaired transportation of Oxygen leads to symptoms and signs of tissue hypoxia Body weakness and fatigue (feeling tired)

• Dizziness, light headedness, lack of concentration

• ‘Pins & needles’  i.e. pinches in the skin

• Leg cramps (muscle pain in the legs)

• Angina pectoris (pain in the chest).

- Blood redistribution from tissue with low oxygen requirement (skin, mucous membrane, kidneys) to those with high oxygen requirement (brain, heart).

 - Hence, paleness of conjunctiva, lips, tongue, palms, nails beds, and soles.

 - Increased cardiac activity leading to:

§  Tachycardia, palpitation and pounding pulse

§  Shortness of breath on exertion

§  Prominence of neck veins ( Jugular veins)

§  Cardiac enlargement

§  Severe oedema of lower limbs, this being sign of congestive cardiac failure. Congestive cardiac failure may lead to death.

 -Other Symptoms and Signs

§  Loss of appetite

§  Pica - desire to eat non-nutritive substances for example eating soil (geophagia) o Dysphagia - difficulty in swallowing

§  Koilonychias - spoon - shaped finger nails.

 

MANAGEMENT OF ANEMIA IN PREGNANCY.

 Mild to Moderate Anaemia (7-11g/dl)

§  Find and treat the cause of anaemia

§  Give the following drugs:

 - Ferrous sulphate 200 mg three times a day

 - Folicacid 5 mg daily

- Antihelminthics: Mebendazole 500 mg (DOT) once after the first trimester

§  Note

-Treat schistosomiasis after delivery

Severe Anaemia (less than 7g/dl)

§  At dispensary/health Centre level where blood transfusion services are not available, give prereferral treatment (diuretics – furosemides) then refer to hospital accompanied by blood donors

§  At hospital level

- Before 36 weeks if the patient is not in heart failure the treatment should be as for mild to moderate anaemia

- After 36 weeks whether in heart failure or not, blood transfusion is required before the woman goes into labor.

 -This is due to shunting of blood from the placental bed into the general circulation which can precipitate heart failure.

- Therefore:

§  Admit the patient

§  treat as severe malaria

§  Also Treat other possible causes

§  Prop up the patient with pillow or clothing

§  Administer oxygen

§  Take blood for grouping and cross matching

§  Give blood transfusion (preferably packed red blood cells) o Continue with ferrous sulphate and folic acid up to 3 months after delivery

§  Follow up patient every 14 days until Hb reaches 11g/dl

 

1. CORONA VIRUS
2. MONKEY POX
3. VAGINAL DRYNESS
4. FIBROID
5. INFERTILITY
6. OVULATION CYCLE
7. OVARIAN CANCER
8. VAGINAL BACTERIA
9. MALE INFERTILITY
10. BEST DAYS OF CONCIEVING
11. MUCUS AFTER OVULATION
12. FOODS FOR ERECTILE FUNCTIONS
13. PREGNANCY ANEMIA
14. DO AND DONT DURING PREGNANCY
15. ERECTILE DYSFUNCTION
16. U.T.I IN PREGNANCY
17. STROKE RISK
18. EAT THIS NOT THAT
19. HOOKWORMS INFECTION
20. OMEGA 3 BENEFITS
21. FASTING
22. WEIGHT LOSS TIPS
23. vitiligo
24. ABORTION
25. DENGUE VIRUS
26. EBORA VIRUS
27. FEVER
28. URINARY TRACT INFECTION
29. HOSPITAL INFECTIONS
30. WEST NILE VIRUS
31. YELLOW FEVER
32. EYE DISEASE
33. ZIKA VIRUS
34. STRESS
35. IRON DEFFICIENCE
36. INSOMNIA (SLEEPING PROBLEMS)
37. HEART PROBLEMS
38. COMPONENTS OF BLOOD
39. BLOOD DISORDER
40. LABORATORY TEST OF BLOOD DISORDER
41. BONE MARROW EXAMINATION
42. BLOOD ANEMIA
43. ANIMAL BITES
44. EYE BURN
45. CHOCKING
46. HEAT STROKE
47. SMOKE EFFECTS
48. SNAKE BITE
49. MALARIA VACCINE
50. BEST WAY TO SLEEP A CHILD
51. CHILD FEVER REDUCING
52. ELEPHANTIASIS
53. WOMEN BEARDS
54. DATES
55. PAPAYA FRUITS