Hematologic Disorders and Pregnancy Flashcards
A Woman With Iron-Deficiency Anemia
- MC complicating ___-__% of all pregnancies
- Results from diet low in Fe, heavy menstrual periods, unwise weight-reducing programs
- Fe level: _______
- Fe-binding capacity: ________
15-25%
- under 30 μg/dl
- over 400 μg/dl
A Woman With Iron-Deficiency Anemia
- Microcytic – __________
- Hypochromic – __________
-S/S:
- Extreme fatigue, poor exercise tolerance
small RBS
less Hgb
- Body recognizes that it needs increased nutrients; craving for subs. Like ice or starch
PICA
Iron-Deficiency Anemia
- Prevention
- Prenatal vits with __mg of iron
- Diet high in ______________ (green leafy veg, legumes, meat)
- Tx
- ________ elemental iron/day
- Ferrous sulfate or ferrous gluconate
27
iron and vitamins
- 120-200 mg
A Woman With Folic Acid Deficiency Anemia
Common in women with:
-
-
-
Secondary hemolytic illness
Hydantoin intake
Poor gastric absorption
A Woman With Folic Acid Deficiency Anemia
- Anemia may cause:
-______________
- _____________
- Prevention:
- ____ μg folic acid daily
- Diet rich in folate (e.g. ________)
-Early miscarriage
- Premature separation of placenta
400
green leafy veg, oranges, dried beans
A Woman With Sickle-Cell Anemia
- Recessively inherited hemolytic anemia
-Presence of _________ (HbS) (AA _________ )
or nonsickling hemoglobin (HbC) (AA ___________)
HbAS - _______
HbSS - _______
sickling hemoglobin
(valine substitution)
(lysine substitution)
Heterozygous sickle-cell trait
Homozygous – sickle cell disease
RBCs are irregular or sickle shaped and cannot carry normal amount of Hgb
Sickle cell anemia
______________ clump together (when O2 tension is reduced as in dehydration or at high altitudes), may block vessels and then hemolyze causing anemia
Sickle cells
A Woman With Sickle-Cell Anemia
Assessment
- Normal Hgb level ________
(with disease)
-
-
-
-
6-8 mg/100 ml
- Presence of bacteriuria
- Presence of varicosities
- UTZ to assess IUGR
- Blood flow velocity (placental perfusion)
______________ are group of autosomal recessively inherited blood disorders that lead to poor hemoglobin formation and severe anemia
Thalassemias
- Thalassemias
- Most frequent in _________ populations
Mediterranean, African and Asian
A Woman With Thalassemia
-
- Folic acid supplementation
- Blood transfusion
__________ is a protozoan infection that is transmitted to people via Anopheles mosquitoes
Malaria
A Woman With Malaria
- Malaria is a protozoan infection that is transmitted to people via ____________
- RBCs stick to the surface of _______ causing obstruction and resulting in ________
Anopheles mosquitoes
- capillaries
- end-organ anoxia
- Can be transmitted by mother-fetus transfusion
- S/S
- Elevated liver function test
- Fever
- Malaise
- Headache
A Woman With Malaria
Prevention: Malaria
- Use of insect repellent, mosquito net
- Delay travel to endemic areas until after pregnancy
Antimalarial drugs
a. Safe in the last trimester
b. DOC
c. not safe
a. Sulfadoxine/pyrimethamine
b. chloroquine
c. quinine, atovaquone, proguanil
__________________________ – not safe in pregnancy and BF
Quinine, atovaquone, proguanil
Most coagulation d/o are sex linked or occurs only in _______
males
- autosomal dominant d/o
- Normal PLT count but prolonged bleeding time
Von Willebrand disease
- Actual disease occurs in males
- Females are carriers and may have reduced level of factor IX
- May cause hemorrhage with labor or spontaneous miscarriage
Hemophilia B (Christmas Disease)
- Decreased no. of platelets, not inherited
- Marked thrombocytopenia (PLT as low as 20,000/mm3) – nosebleeds, petechiae, ecchymoses
- Assumed to be an autoimmune reaction
Idiopathic thrombocytopenic purpura (ITP)
Risks of IDA in pregnancy
a. LBW
b. preterm birth
