Anaemia in pregnancy Flashcards
What complications does anaemia predispose to in pregnancy?
Small PPHs becoming life threatening PPH Infection Worsens HF perinatal problems s malaria
What is anaemia during pregnancy defined as?
Definition: Hb <105g/L
What are the physiological changes in Hb in pregnancy?
steep fall around 20 weeks
What are RF for anaemia in pregnancy?
- Those who start pregnancy anaemic e.g. menorrhagia, hookworm, malaria, w haemoglobinopathies
- Frequent pregnancies
- Twin pregnancy
- Poor diet
When can anaemia be identified in pregnancy?
Hb estimation at booking and 28 weeks
What group of patients should be identified for sickle cell anaemia?
black pts
What are investigations, what would u expect to see?
- FBC - reduced MCV
- In iron deficiency - serum iron, TIBC and serum ferritin reduced
- in folate deficiency - raised MCV, serum and red cell folate decreased
What are causes of anaemia in pregnancy?
- Iron deficiency
- Folate deficiency
- Coeliac, CKD and autoimmune disease
How much does pregnancy increase iron needs?
by 700-1400mg
What is Rx
- Iron and folate supplements
- Oral iron e.g. ferrous sulphate
- Parenteral iron in those who would refuse blood transfusion as iron dextran or iron sucrose
When is iron contraindicated as a treatment for anaemia
thalassaemia
iron levels already high
What should be given for pregnant women w sickle cell disease?
penicillin pneumococcal prophylaxis can be started