Anaemia in pregnancy

Question 1

What complications does anaemia predispose to in pregnancy?

Answer 1

Small PPHs becoming life threatening 
PPH
Infection
Worsens HF
perinatal problems s malaria

Question 2

What is anaemia during pregnancy defined as?

Answer 2

Definition: Hb <105g/L

Question 3

What are the physiological changes in Hb in pregnancy?

Answer 3

steep fall around 20 weeks

Question 4

What are RF for anaemia in pregnancy?

Answer 4

• Those who start pregnancy anaemic e.g. menorrhagia, hookworm, malaria, w haemoglobinopathies
• Frequent pregnancies
• Twin pregnancy
• Poor diet

Question 5

When can anaemia be identified in pregnancy?

Answer 5

Hb estimation at booking and 28 weeks

Question 6

What group of patients should be identified for sickle cell anaemia?

Answer 6

black pts

Question 7

What are investigations, what would u expect to see?

Answer 7

1. FBC - reduced MCV
2. In iron deficiency - serum iron, TIBC and serum ferritin reduced
3. in folate deficiency - raised MCV, serum and red cell folate decreased

Question 8

What are causes of anaemia in pregnancy?

Answer 8

1. Iron deficiency
2. Folate deficiency
3. Coeliac, CKD and autoimmune disease

Question 9

How much does pregnancy increase iron needs?

Answer 9

by 700-1400mg

Question 10

What is Rx

Answer 10

1. Iron and folate supplements
2. Oral iron e.g. ferrous sulphate
3. Parenteral iron in those who would refuse blood transfusion as iron dextran or iron sucrose

Question 11

When is iron contraindicated as a treatment for anaemia

Answer 11

thalassaemia

iron levels already high

Question 12

What should be given for pregnant women w sickle cell disease?

Answer 12

penicillin pneumococcal prophylaxis can be started