a. Deficiency: Iron, Folic A., Vitamin B12 b. Hemorrhagic: APH, Hookmworm c. Hereditary: Thalassemia, Sickle, H. Hemolotyic Anemia d. Bone Marrow Insufficiency: Aplastic Anemia e. Infections: Malaria, TB f. Chronic Renal Diseases or Neoplasm
Labs:
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Hb 7.1 gm/dl, Hct 23%
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WBC 5,400/mm3 (differenctial is normal)
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Platelets 450,000/mm3
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Mean Corpuscular volume (MCV) is 74 fl (normal 85-95f l)
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Red cell Distribution Width (RDW) is 17.1% (normal 13-15).
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Hemoglobin below 11gm/dl in 1st and 3rd trimester and below 10.5gm/dl in second trimester.
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11gm/dl or less
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By this standard, 50% of women not on hematinics become anemic
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Anaemia may affect 1-% of pregnancies in developed countries and is considerably commoner in developing contries, where it is a major source of meternal morbidity and a contributor to mortality.
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Up to 56% of all women living in developing countries are anaemic (Hb < 11 g/dl) due to infestations
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Physiologic
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Pathologic:
a. Deficiency: Iron, Folic A., Vitamin B12 b. Hemorrhagic: APH, Hookmworm c. Hereditary: Thalassemia, Sickle, H. Hemolotyic Anemia d. Bone Marrow Insufficiency: Aplastic Anemia e. Infections: Malaria, TB f. Chronic Renal Diseases or Neoplasm
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Disproportionate increase in plasma vol, RBC vol. and hemoglobin mass during pregnancy
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Marked demand of extra iron during pregnancy especially in second trimester
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Hb: 10gm%
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RBC: 3.2 million/mm3
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PCV: 30%
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Peripheral smear showing normal morphology of RBC with central pallor
1.
To meet the demands of the enlarged uterus with its greatly hypertrophied vascular system.
2.
To protect the mother, and in turn the fetus, against the deleterious effects of impaired venous return in the supine and erect positions.
3.
To safeguard the mother against the adverse effects of blood loss associated with parturition
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Normal hemoglobin by gestational age in pregnant women taking iron supplement
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12 wks 12.2 [11.0 - 13.4]
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24 wks 11.6 [10.6 - 12.8]
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40 wks 12.6 [11.2 - 13.6]
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Iron loss: sweat, repeated pregnancy, hookworm infestation and malaria
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Faulty absorption mechanism: due to high incidence of intestinal infestation there is intestinal hurry
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Faulty diet habit: rich carbohydrate and high phosphate reduce absoprtion of iron
