Physiological Anaemia of Pregnancy

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ANAEMIA

Anaemia is a reduction in the oxygen carrying capacity of the blood; this may be caused by a decrease in red blood cell (RBC) production, or reduction in haemoglobin (Hb) content of the blood.

Sign and Symptoms

Pallor
Fatigue
Dizziness
Shortness of breathe on exertion
Pale mucous membranes
Fainting
Palpitations
Tachycardia

Cause

Dietary deficiency
Numerous pregnancies
Menorrhage
Chronic infection
Antepartum haemorrhage
Postpartum haemorrhage

Physiological Anaemia of Pregnancy

During pregnancy there is an increase in the maternal plasma volume, by up to 50%.

This haemodilution causes a drop in the Hb. This is NOT pathological.

Iron Deficiency Anaemia

MCV (Mean Cell Volume) and MCHC (Mean Cell Haemogloblin Concentration) are used to indicate the cause of the anaemia

Microcytic anaemia refers to a low MCV

Hypochromic anaemia refers to low MCHC.

MANAGEMENT

Ideally the iron status should be assessed prior to pregnancy. •Prescribe supplements where there is a Hb level of 9 -10g/dl. •Iron supplements can cause gastrointestinal disturbance. Advise women to take iron after meals. •Avoid taking iron supplements with caffeine e.g. Coffee, Cola, Tea. •A drink with vitamin C enhances the iron uptake.

NB.Women with adequate iron stores should not take iron supplements. High Hb levels are likely to make RBCs macrocytic and the blood becomes more viscose. This affects uterooplacental blood flow and decrease placental perfusion.

Folic Acid Deficiency anaemia

Folic acid is needed for the increased cell growth in both the mother and the fetus. The MRC Vitamin Study Research Group (1991) found a positive correlation between folate deficiency and the development of neural tube defects in the fetus.

The signs and symptoms are similar to the signs of the minor disorders of pregnancy.

This condition is termed macrocytic or megaloblastic anaemia. The MCV rises...
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