Anaemia In Pregnancy

Question 1

What are the levels of anaemia in pregnant

Answer 1

1st trimester: <11g/dL
2nd →<10,5G/dL
3rd →<10,5G/dL
Post partum<10,5G/dL

Question 2

What are the causes of anaemia

Answer 2

• nutritional: folate and vitamin BI2 deficiency
• acute or chronic blood loss - GI bleeding
• infections: HIV and malaria
• parasites
• chronic - renal, cancers

Question 3

Clinical signs

Answer 3

Pallor -
Blue sclera-
Pale conjuctiva
Tachycardia
Skin and nail changes
Gum and younger changes
Shortness of breath

Question 4

Effect of anaemia on pregnancy

Answer 4

PET, Abruptio, UTI, increased risk of PPH, lactation failure, puerperal sepsis

Question 5

Effects on fetus

Answer 5

IUGR, LBW, prematurity, low agar scores, cognitive dysfunction

Question 6

What is the work up of anaemia

Answer 6

Good history

*examination pallor, glossitis, splenomegaly, jaundice, purport, cardiac failure, chronic disease

Question 7

Investigations

Answer 7

Hb at first visit and 28 week
Type of anemia: (microcytic, macrocytic, normocytic, haemolytic and pancytopaenia
Reticulocyte count

Question 8

What are special investigation

Answer 8

Serum ferritin [<20ng/ml]→ iron stores s 40-160ng/dL]

Serum iron [ 65-165 ug/dl]

Question 9

Other investigations

Answer 9

Urine for RBC
Stools for occult blood ova
Bone marrow for refractory anaemia
CXR to exclude PTB
Serum creatinine: renal disease

Question 10

Treatment

Answer 10

Rx orally at home, Blood transfusion, admit if hb<7 or above 34 weeks

Question 11

If patient is in second trimester or not responding to oral iron

Answer 11

Consider parental iron IV or IM → venofir target 11g/dL

What are other indications : contra-indicated for oral, not cooperative oral, severe anaemia in 8-10 week

Question 12

What are indications for Blood transfusion

Answer 12

PPH, severe anaemia in later months of pregnancy, refractory anaemia, asocial section