Anaemia in Pregnancy Flashcards
1
Q
Define anaemia in pregnancy.
A
- < 110 g/L in 1st trimester
- < 105 g/L in 2nd/3rd trimester
- < 100 g/L postpartum
- < 70 g/L – URGENT REFERRAL
2
Q
What are the risk factors for anaemia in pregnancy?
A
- Multiple pregnancy
- 2 pregnancies close together
- Lots of vomit due to morning sickness
- Pregnant teenager
- Anaemia before becoming pregnant
- Diet - esp. iron deficiency
3
Q
What are the specific signs of B-12 deficiency anaemia?
A
- Glossitis
- Depression
- Psychosis/dementia
- Paraesthesia
- Peripheral neuropathy
4
Q
What are the appropriate investigations for anaemia in pregnancy?
A
- FBC
- Blood fil
- Iron = hypochromic, microcytic, pencil cells
- Folate = megaloblastic
- B12 = megaloblastic
- Iron studies
5
Q
What are the iron study results of:
- Iron deficiency
- Anaemia of chronic disease
- Chronic haemolysis
- Haemochromatosis
- Pregnancy
- Sideroblastic anaemia
A
6
Q
What is the management of anaemia in pregnancy?
A
-
Supplements
- Iron = oral ferrous sulphate
- Folate = oral folic acid
- B12 = IM hydroxycobalamin
-
Diet and advice
- Iron = green leafy vegetables, nuts, beans, seeds
- Folate = green leafy vegetables, nuts, yeast, liver
- B12 = meat and dairy
7
Q
What are the common side effects of oral ferrous iron?
A
- Black stool
- Constipation
- Abdominal pain
8
Q
When must you not give oral folic acid?
A
- If cause not known
- Can exacerbate B12 symptoms if that is the cause
9
Q
What is the management of anaemia intra-partum?
A
- Deliver in consultant-led unit
- IV access and group and screen on admission
- Active management of 3rd stage
- Active management of PPH
- Consider prophylactic syntocinon infusion
10
Q
What are the complications of anaemia in pregnancy?
A
- Preterm or LBW (Low Birth Weight) baby
- Postpartum depression
- Child with developmental delays
- Spina bifida
- Prognosis is good/normal in most cases
