Anaemia and pregnancy Flashcards
When are women routinely screened for anaemia and pregnancy
twice
Booking clinic
28 weeks gestation
Why is aneamia in pregnancy higher risk than before?
Plasma volume increases - reduced Hb conc as blood is diluted
Anaemia in pregnancy presentation
SOB
Fatigue
Dizziness
Pallor
Anaemia in pregnancy presentation
SOB
Fatigue
Dizziness
Pallor
Normal ranges for Hb - booking bloods, 28 weeks gestation and Post Partum
Booking bloods >110g/l
28 weeks >105 g/l
PP >100g/l
What does low MCV indicate about anaemia
Iron deficiency
What does normal MCV indicate about anaemia
Physiological - due to increased plasma volume
Raised MCV indications about anaemia
B12 or foalte deficiency
What screenings related to anaemia at booking clinic
Thalassemia - all
sickle cell disease - high risk women
Additional investigations for anaemia
Not routinely performed
Ferritin
B12
Folate
What is mnamgement of anaemia?
Ferrous sulphate (iron replacemetn) 0mg 3 x a day
Why get low B12 in pregnancy
High plasma volume
Requirements for B12 from pregnancy
What can precipitate wernickes encephalopathy
IV dextrose solutions
What causes osmotic demyelation syndrome
Severe hyponatremia + rapid correction
What is osmotic demyelation syndrome
Centra pontine myelinolysis
Symptoms of wernickes encephalopathy
Diplopia, abnormal ocular movements, ataxia, confusion
Signs of wernickes encephalopahty
6th nerve palsy
Gaze palsy
Nystagmus
What should women with low B12 be tested for?
Pernicious anaemia - check for intrinsic factor antibodies
Treatment for low B12 in pregnancy
IM hydroxocobalamin injections
Oral cyanocobalamin tablets
Why can removing an ovary ni pregnancy lead to miscarraige?
Remove corpus luteum
therefore remove the hormones allowing pregnancy before placenta takes over
Treatment for thalassaemia and sickle cell anaemia
Folic acid 5mg daily, close monitoring and transfusions
