Anaemia in Pregnancy Flashcards
What is anaemia in pregnancy?
Anaemia in pregnancy is defined as a haemoglobin (Hb) level below the normal range for pregnant women, typically <110 g/L in the first trimester, <105 g/L in the second/third trimester, and <100 g/L postpartum.
What is the most common cause of anaemia in pregnancy?
The most common cause is iron-deficiency anaemia due to increased iron demands during pregnancy.
What are the physiological changes in pregnancy that affect haemoglobin levels?
Plasma volume increases more than red blood cell mass, causing physiological haemodilution and a relative reduction in haemoglobin.
What are the main types of anaemia in pregnancy?
Types include iron-deficiency anaemia, folate-deficiency anaemia, vitamin B12 deficiency, and anaemia of chronic disease.
What are the symptoms of anaemia in pregnancy?
Symptoms include fatigue, weakness, pallor, shortness of breath, dizziness, and palpitations.
What are the risk factors for anaemia in pregnancy?
Risk factors include poor dietary intake, multiple pregnancies, close birth spacing, and heavy menstrual bleeding before pregnancy.
How is anaemia in pregnancy diagnosed?
Diagnosis is based on haemoglobin levels measured during antenatal blood tests, typically at booking and at 28 weeks.
What additional tests are performed if anaemia is suspected in pregnancy?
Tests include serum ferritin (iron stores), mean corpuscular volume (MCV), and peripheral blood smear to identify the type of anaemia.
What are the typical findings in iron-deficiency anaemia on blood tests?
Findings include low haemoglobin, low serum ferritin, low MCV (microcytosis), and hypochromic red blood cells.
What is the first-line treatment for iron-deficiency anaemia in pregnancy?
First-line treatment is oral iron supplements, such as ferrous sulfate or ferrous fumarate.
How is folate-deficiency anaemia treated in pregnancy?
Treatment involves folic acid supplementation, typically 5 mg daily.
How is vitamin B12 deficiency managed in pregnancy?
Management includes intramuscular vitamin B12 injections, particularly in women with pernicious anaemia or strict vegetarian diets.
When is intravenous iron indicated in pregnancy?
IV iron is indicated if oral iron is poorly tolerated, ineffective, or if anaemia is severe and rapid correction is needed.
What are the side effects of oral iron supplements?
Side effects include nausea, constipation, diarrhoea, and dark-coloured stools.
What are the complications of untreated anaemia in pregnancy?
Complications include preterm delivery, low birth weight, maternal fatigue, increased risk of infection, and postpartum haemorrhage.
What is the recommended daily iron intake for pregnant women?
The recommended daily intake is 30-60 mg of elemental iron.
What are the dietary sources of iron?
Dietary sources include red meat, poultry, fish, leafy green vegetables, legumes, and fortified cereals.
How can the absorption of dietary iron be improved?
Iron absorption is enhanced by consuming vitamin C-rich foods (e.g., citrus fruits) and avoiding tea or coffee with meals.
What is the role of routine antenatal blood tests in detecting anaemia?
Routine tests at booking and 28 weeks identify anaemia early, allowing timely intervention to prevent complications.
How is anaemia of chronic disease managed in pregnancy?
Management focuses on treating the underlying condition, with iron supplementation only if true iron deficiency is present.
What is the significance of low ferritin levels in pregnancy?
Low ferritin indicates depleted iron stores, confirming iron-deficiency anaemia as the cause.
How is haemoglobinopathy screening relevant to anaemia in pregnancy?
Screening identifies inherited conditions like sickle cell disease or thalassaemia, which may complicate anaemia management.
How does multiple pregnancy increase the risk of anaemia?
Multiple pregnancy increases iron and folate demands, making anaemia more likely.
What are the postpartum considerations for women with anaemia?
Postpartum women should be monitored for persistent anaemia and provided with continued iron or folate supplementation as needed.
How can anaemia in pregnancy be prevented?
Prevention involves routine antenatal supplementation with iron and folic acid, along with dietary counselling.
