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ANAEMIA IN PREGNANCY

ANAEMIA IN PREGNANCY. AHMED ABDULWAHAB. It is the commonest medical disorder of pregnancy. Physiological changes. Plasma volume increase by 50%. Red cell mass increase by 25%. Fall in Hb concentration and haematocrit due to haemodilution. MCV increase secondary to erythropoiesis. Cont,

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ANAEMIA IN PREGNANCY

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  1. ANAEMIA IN PREGNANCY AHMED ABDULWAHAB

  2. It is the commonest medical disorder of pregnancy. • Physiological changes. • Plasma volume increase by 50%. • Red cell mass increase by 25%. • Fall in Hb concentration and haematocrit due to haemodilution. • MCV increase secondary to erythropoiesis.

  3. Cont, • MCHC remain stable. • Serum iron and ferritin decrease because of utilization . • Total iron binding capacity increases TIBC • Iron requirement increases total of 1000mg in whole pregnancy. • Moderate increase in iron absorption . • Folate requirement increases

  4. DEFINTION.. • WHO recommended that Hb concentration should fall below 11gm/dl in pregnancy to diagnose anemia. • Incidence 30-50% pregnant women are having anemia at pregnancy. • 90% have iron deficiency anemia . • 5% folate deficiency .

  5. CLINICAL FEATURE. • Often asymptomatic. • Diagnosed in routine screening . • Other ,tiredness, dizziness ,fainting , pallor may be apparent

  6. SCREENING . • Routine screened by Hb concentration at the beginning of pregnancy . • It is cheep and simple.. • It does not reveal the cause .

  7. IRON DEFICENCY ANAEMIA . • It is microcytic hypochromic . Reduced MCV . MCHC. • Etiology . • Increase demand in pregnancy due to expanding red cell mass, fetal requirement .If iron stores are depleted because of menstruation , recurrent pregnancy ,poor intake , anemia develops rapidly

  8. CONSEQUENCES . • Preterm labor. • Infection • Medical intervention during labor . • Post partum blood loss. • ? IUGR.

  9. TREATMENT. • Oral iron is effective when there is time . • Hb increase 0.8 g/dl per week • Ferrous salt is better absorbed than the ferric form . • Side effect depends on the amount of the of the elemental iron . • Choice depends on cost and patient tolerance .

  10. Cont. • Vitamin –C helps absorption . • Main side effect are gastro intestinal , gastric upset and constipation . • Indication for parenteral thereby . • Lack of compliance , severe GIT side effect, mal absorption • Intera muscular iron sorbitol

  11. Cont. • Deep im it is painful cause discoloration of the skin . • High level may be excreted before utilization . • IV IRON . • Iron saccharate cause more rapid rise in Hb and has fewer side effect. Compared

  12. Cont • To oral iron but more invasive , need admission to hospital , it is true alternative to blood transfusion. • Blood transfusion , • Most rapid way to increase the Hb . • Used when there is no time to correct anemia . • Risks include allergy and transmission of infection

  13. Cont. • Prevention is possible with good balanced diet . • Identification and treatment of iron deficiency prior to pregnancy are optimal . • Routine iron supplementation in pregnancy improve in hematological indices.

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