Anaemia and pregnancy

Question 1

When are women routinely screened for anaemia and pregnancy

Answer 1

twice
Booking clinic
28 weeks gestation

Question 2

Why is aneamia in pregnancy higher risk than before?

Answer 2

Plasma volume increases - reduced Hb conc as blood is diluted

Question 3

Anaemia in pregnancy presentation

Answer 3

SOB
Fatigue
Dizziness
Pallor

Question 4

Anaemia in pregnancy presentation

Answer 4

SOB
Fatigue
Dizziness
Pallor

Question 5

Normal ranges for Hb - booking bloods, 28 weeks gestation and Post Partum

Answer 5

Booking bloods >110g/l
28 weeks >105 g/l
PP >100g/l

Question 6

What does low MCV indicate about anaemia

Answer 6

Iron deficiency

Question 7

What does normal MCV indicate about anaemia

Answer 7

Physiological - due to increased plasma volume

Question 8

Raised MCV indications about anaemia

Answer 8

B12 or foalte deficiency

Question 9

What screenings related to anaemia at booking clinic

Answer 9

Thalassemia - all
sickle cell disease - high risk women

Question 10

Additional investigations for anaemia

Answer 10

Not routinely performed
Ferritin
B12
Folate

Question 11

What is mnamgement of anaemia?

Answer 11

Ferrous sulphate (iron replacemetn) 0mg 3 x a day

Question 12

Why get low B12 in pregnancy

Answer 12

High plasma volume
Requirements for B12 from pregnancy

Question 13

What can precipitate wernickes encephalopathy

Answer 13

IV dextrose solutions

Question 14

What causes osmotic demyelation syndrome

Answer 14

Severe hyponatremia + rapid correction

Question 15

What is osmotic demyelation syndrome

Answer 15

Centra pontine myelinolysis

Question 16

Symptoms of wernickes encephalopathy

Answer 16

Diplopia, abnormal ocular movements, ataxia, confusion

Question 17

Signs of wernickes encephalopahty

Answer 17

6th nerve palsy
Gaze palsy
Nystagmus

Question 18

What should women with low B12 be tested for?

Answer 18

Pernicious anaemia - check for intrinsic factor antibodies

Question 19

Treatment for low B12 in pregnancy

Answer 19

IM hydroxocobalamin injections
Oral cyanocobalamin tablets

Question 20

Why can removing an ovary ni pregnancy lead to miscarraige?

Answer 20

Remove corpus luteum
therefore remove the hormones allowing pregnancy before placenta takes over

Question 21

Treatment for thalassaemia and sickle cell anaemia

Answer 21

Folic acid 5mg daily, close monitoring and transfusions