Heamatological Changes In Preganancy Flashcards
Haematology Al changes in pregnancy include
Physiologic anemia
Prothrombotic changes
Increased plasma volume
Mild neutrophilia
Plasma volume increase in first 6-12 was of pregnancy
10-15%
Plasma volume expands up to what week before it begins to plateau
30-34 wks
Total gain at term
1.1-1.2L
Plasma volume at term
4.7-5.2
30-50% above non pregnant woman
Sodium and water retained with increased plasma volume
1000meq sodium
6-8 L of water
What causes increase in plasma volume
A response to underfilled vascular system caused by
Systemic Vasodilation Increase vascular capacitance Plasma renin increases Atrial natriuretic peptide levels reduced High hydration from mother High colloid oncotic pressure
Red blood cell mass increases at
8-10 wks
20-30% higher than non pregnant women at end of gestation
MCV in pregnancy
Increases due to increase in RBC volume
Why anemia in pregnancy
Increase in plasma volume far greater than increase in RBC
Erythropoietin levels
Increase by 50%
When does neutrophil count begin to increase
2nd month of pregnancy
When does WBC count plateau
2 to 3 trimester and ranges from 9000-15000
Metalocytes and my elicited
Small number seen in peripheral circulation
In WBC are found
Doyle bodies
Blue staining cytoplasmic inclusions
The absolute lymphocyte count and T and B lymphocytes
Do not change
Monocyte count
Stable
Basophil count
Decrease slightly
Eosinophil count
Increase slightly
Platelet count
Declines as pregnancy progresses but still in non pregnant range 150,000-450000
Cause of decline in platelet count
Gestational thrombocytopenia
Prothrombotic state in pregnancy
Prevents excess haemorrhage in placental seperation
Prothrombotic state and increase in coagulation factors risk
Thromboembolism
PAI-1 levels
Increase
Is derived from placenta and decidua
Factor 8 levels
Decrease in 2-3 trimester
APTT in pregnancy
Normal range
Shortens near term
PT
Shortens
D dimer diagnosis of TE
Cannot since it increases in pregnancy
Hbf affinity for oxygen
High affinity
O-Hb dissociation Curve shifts to the left
2,3 bpg binds less strongly to Hbf
Arterial O pressures in neonates
Reduced
19mmHg as compared to 27 mmHg in adults
Normal neonatal hb
18-20g/dl
Uremic plasma expresses this on RBC
Phosphatidyl serine in order to be recognized by macrophage
Erythropoietin levels can affect
Platelet levels bc of its relation to thrombopoietin
Erythropoietin potentiates the effect of
Megakaryocyte colony stimulating factors acetylhydroase paraxoase
