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Anemia in pregnancy

By:  Dr. Umesh N Jindal On:  August 31, 2016 8:44 AM
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efinition: According to WHO guidelines – Haemoglobin level < 11.0 g in pregnancy. Indian standard – Haemoglobin level less than 10.5 g

Cause:

  • Iron deficiency Anaemia
  • Dietary deficiency
  • Worm infestations
  • Repeated pregnancies at short intervals
  • Megaloblastic Anaemia – commonly due to folic acid deficiency in pregnancy
  • Thalassemias
  • Hemoglobinopathy – Inherent Defect in structure of haemoglobin which results in defective synthesis of Hb in red cells.

Symptoms:

General weakness, fatigue. In severe deficiency breathlessness on exertion and generalized swelling of body may occur. Sometimes even heart failure can occur in very severe cases.

Diagnosis:

A complete hemogram which includes haemoglobin, red cell count, red cell, Hb concentration and peripheral blood film is the main test. More specific tests like serum iron profile, Hb electrophoresis, etc. may be required to define the exact cause of anaemia.

Worm infestation can be prevented by washing hands properly, washing vegetables, fruits thoroughly before cooking or eating & not passing stools in open /unhygienic areas.
Spacing childbirth – At least 2 yrs interval is needed to replenish the iron stores depleted during pregnancy.

Treatment:

Since nutritional deficiency is the commonest cause of anaemia a diet rich in iron e.g. green leafy vegetables (spinach, methi, peas), gram flour (besan) chick pea (channa), eggs, meat (especially organ meat like liver), poultry etc. is required. Iron and folic acid supplementation during pregnancy and throughout lactation.

Some patients get constipation or diarrhea, acidity, bad taste, etc. with iron tablets and do not want to take it. In such patients intra muscular injections of iron are prescribed. In severe anemia (Hb < 6.0 g); blood transfusion may also be needed to prevent heart failure.