anemia in pregnancy

To know physiological changes in blood during pregnancy.
To understand definition, types and aetilogy of anemia in pregnancy.
To know how to diagnose and treat various types of anemia in pregnancy.Iron deficiency anaemia is a significant problem
worldwide, affecting 50% of pregnant women (56% in developing and 18% in developed countries).
Incidence is lower in developed countries due to :-
1.Better living slandered & nutrition.
2.Smaller & better- spaced families.
3.Wide spread use of oral contraception which usually decrease menstrual loss. Plasma volume increase by 20% by 15 weeks & 50% by 30-34 weeks (1250 ml).
RBC increase by 14% (180 ml) without supplementation iron & 28 %( 350 ml) when extra iron & folic acid given.R.B.C mass will increase due to increase erythropoietin (possibly due to HPL).
Because there is greater increase in plasma volume than of the RBC this will lead to hemodilution & physiological anemia. (MCV) which increases by about 4–6 fL, secondary to greater numbers of larger
young red cells from the increase in red cell mass.
? white cell count: ? neutrophils, ? monocytes, ? lymphocytes
Mild thrombocytopenia with no impairment of platelet function.
Prothrombotic state predominantly due to increases
in FVIII, vWF, fibrinogen and reduction in protein S.