Anemia in pregnancy

Question 1

Values for microcytic, normocytic and macrocytic:

Answer 1

microcytic: <80fL
normocytic: 80-100fL
macrocytic: >100fL

Question 2

Causes of microcytic anemia?

Answer 2

Iron deficiency anemia
    Thalassemias
    Anemia of chronic disease
    Sideroblastic anemia
    Copper deficiency
    Lead poisoning

Question 3

Causes of macrocytic anemia?

Answer 3

Folic acid deficiency anemia
Vitamin B12 deficiency
Drug-induced hemolytic anemia (eg, zidovudine)
Reticulocytosis
Liver disease
Ethanol abuse

Question 4

Who should be screened for anemia during pregnancy?

Answer 4

All pregnant women should be screened for anemia during pregnancy.

Question 5

How should asymptomatic pregnant women with mild to moderate anemia be evaluated?

Answer 5

History & physical
LAB:
CBC w/Diff
serum iron levels, and ferritin levels.
[Peripheral smear is helpful for diagnosis of hemolytic or parasitic disease]

Question 6

Iron deficiency anemia during pregnancy has been associated with:

Answer 6

Low birth weight, preterm delivery, and perinatal mortality.

Question 7

When should maternal transfusion be considered for fetal indications?

Answer 7

Severe anemia with maternal Hgb levels less than 6 g/dL is associated with abnormal fetal oxygenation resulting in nonreassuring fetal heart rate patterns, reduced amniotic fluid volume, fetal cerebral vasodilatation, and fetal death.

Question 8

What types of macrocytic anemia are there?

Answer 8

Megaloblastic [b-12, folate or pernicious]

or nonmegaloblastic [liver/alcoholism]

Question 9

Macrocytic anemia with values equal to or > 115 fL:

Answer 9

Megaloblastic

Question 10

Failure to respond to iron therapy may suggest?

Answer 10

Incorrect diagnosis, coexisting disease, malabsorption (sometimes caused by concomitant use of antacids), noncompliance, or blood loss.