17 - Anemia In Pregnancy

Question 1

Most important physiological changes in pregnancy:

Answer 1

1– Increase in plasma and RBCs mass
2– Physiological anemia
3– Increased Fe+ requirement
4– Hypercoagulable state

Question 2

Lower limit Hb normal values:

Answer 2

Non-pregnant —> 11.5–12

Pregnant —> 10.5

Question 3

MC anemia type:

Answer 3

Fe+ anemia

Question 4

Fe+ anemia results in:

Answer 4

1– Poor absorption
2– Poor diet and Fe+ intake
3– Increased demand [In multiple gestation, blood loss and hemolysis]
4– If her Fe+ stores got depleted as a result of [Menorrhagia, recent pregnancy, conception while lactating]

Question 5

Anemia effect in fetuses:

Answer 5

1– Increased IUGR
2– Preterm birth
3– NTD [ONLY IN FOLATE ANEMIA]

Question 6

Fe+ anemia changes in blood:

Answer 6

1– Low MCV, MCH, MCHC, serum Fe+ and ferritin
2– Microcytic and hypochromic
3– Increased Total binding capacity

Question 7

Folate anemia changes in blood:

Answer 7

1– Increased MCV, RDW
2– Microcytic
3– Hypersegmented neutrophils

Question 8

RF for FDA:

Answer 8

1– Anticonvulsant therapy [Phenytoin, phenobarbital]
2– Chronic hemolytic anemia [SC anemia]
3– Thalassemia 
4– Hereditary spherocytosis 
5– Frequent pregnancy

Question 9

Folate intake dosages:

Answer 9

Routinely —> 0,4 mg/day

In previous NTD baby —> 5 mg/day