Anemia in Pregnancy



Anemia in Pregnancy
Anemia in Pregnancy 




Normal haematological events associated with pregnancy.

- During pregnancy there is a 36% increase in the blood volume, the maximum is reached at 34 weeks gestation.

- The plasma volume increases 47-50 % and RBSs mass Increases only 17 % and reaches its maximum at term.

- There is relative hemodilution throughout pregnancy, and this reaches its maximum at 28 – 34 weeks.

This dilution effect lowers the Hb, HCT, and RBCs count, it causes no change in the MCV or MCH.

Definition

- Hb value below the lower limits of normal not explained by the state of hydration.

- Anemia during pregnancy 11 or 10.5 g/dl.

- Anemia is defined as the reduction in the total circulating red blood cells.

- 20 – 60 % of prenatal patients will be found to be anaemic at sometimes during pregnancy.

Causes of anemia during pregnancy:

1- Acquired:

- Iron deficiency anemia.

- Anemia caused by acute blood loss.

- Anemia of inflammation or malignancy.

- Megaloblastic anemia.

- Acquired hemolytic anemia.

- Aplastic or hypoplastic anemia.

2- Hereditary:

- Thalassemia.

- Sickle cell hemoglobinopathies.

- Other hemoglobinopathies.

- Hemolytic anemia Hereditary.

Red blood cell disorders during pregnancy:

1- Decreased erythrocyte production.

- Iron deficiency.

- Thalassemia.

- Chronic disease.

- Bone marrow failure.

- Inflammation process.

- Malignancy.

- Folate deficiency.

- Vit b12 deficiency.

2- Increase erythrocyte loss.

- Hemolytic anemia.

- Chemical toxicity.

- Hemoglobinopathies.

- Clinical presentation.

Symptoms caused by anemia are those resulting from :

1 - Tissue hypoxia: fatigue, weakness, pallor and exertional dyspnea.

2 - Cardiovascular system attempts to compensate for the anemia: palpitation and tachycardia.

3 - an underlying disease:

- Chronic infection.

- Chronic renal disease.

- Chronic liver disease.

- Multiple pregnancies.

Severe anemia is associated with :

- Congestive heart failure.

- Multi-organ failure.

- Tissue hypoxia.



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