anemia in pregnancy

? 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.The lower normal limit of Hb during
pregnancy is 11 gm/dl, & PCV is 37%.
?
? Diagnosis of anemia in pregnancy:-
? Hb 10 gm / dl, pcv: 35 %.1.? ability to withstand the effects of obstetric
hemorrhage.
2. Severe anemia predispose to infection.
3. It may ? risk of thrombo –embolism.
4. It predispose to decompensation in mother
with cardiac or respiratory disease. High output
cardiac failure is likely when Hb < 5g%.
5. Delayed physical recovery especially after c/s
& in multipara.
On the other hand, the effects of maternal iron
deficiency anemia on the fetus are negligible &
the baby has normal cord blood Hb level80% of anemia in pregnancy is IDA.
? In non- pregnant women iron requirement is
1 mg/day. During pregnancy there is ? iron
requirement about 3.5 mg/day.
? Fetus, placenta: 500mg iron
? Increase RBC mass 500mg
? Postpartum blood loss: 180 mg
? Lactation for 6 months: 180 mg
? Total requirement: 1360 mg iron. From this
350 mg may save as a result of amenorrhea
of pregnancy, so the actual demand during
pregnancy is 1000 mg.