PB 233: Anemia in Pregnancy Flashcards
What are the 2 most common causes of anemia in pregnancy?
Iron deficiency
Acute blood loss
What is the definition of anemia in pregnancy (Hgb/Hct) in each trimester?
1st: <11 g/dL or 33%
2nd: <10.5 g/dL or 33%
3rd: <11 g/dl or 33%
What is the physiology of anemia in pregnancy?
Increased iron requirement because plasma volume expands 40-50%, and erythrocyte mass expands only by 15-25%
What test has the highest sensitivity and specificity for diagnosing iron deficiency anemia? What value is diagnostic?
Serum ferritin < 30 mcg/dL confirms IDA
True or False: The CDC recommends implementing universal iron supplementation to meet the iron requirement of pregnancy except in the presence of certain genetic disorders (eg hemochromatosis).
TRUE
Low-dose iron supplementation is recommended starting in the first trimester to decrease the prevalence of maternal anemia at delivery
What is the recommended daily dietary intake of ferrous iron during pregnancy? during lactation?
During pregnancy: 27 mg
During lactation: 9 mg
*Perinatal iron supplementation is important because the typical American diet and endogenous stores are insufficient sources for the increased iron requirements during pregnancy.
What are the risks of iron deficiency anemia during pregnancy?
How should it be treated?
Risks:
Low birth weight
Preterm delivery
Perinatal morbidity
Treatment:
Iron supplementation + Prenatal vitamin
At what Hgb level is transfusion indicated in the antepartum period?
6 g/dL
Severe anemia is associated with abnormal fetal oxygenation, resulting in NRFHT, reduced amniotic fluid volume, fetal cerebral vasodilation, and fetal death
When should parenteral iron be used in pregnant patients?
Parenteral iron can be considered for those who cannot tolerate or do not respond to oral iron or for those with severe iron deficiency later in pregnancy (due to greater likelihood of achieving target hemoglobin)
