obstetrics .3- ANAEMIA IN PREGNANCY.ppt.

anemia in pregnancy

1. ANAEMIA IN PREGNANCY
AHMED ABDULWAHAB

2. •objectives
•1-describe the physiological changes in
pregnancy increasing the risks of anemia
•2-List the different types of anemia in
pregnancy
•3-Describe the sign and symptoms in
anemic pregnant lady
•4-List the different investigations to
identify the causes of anemia
•5-justify different mode of managements

3. •Justify different mode of managements for
anemia according to types severity and
gestational age .

4. •It is the commonest medical disorder of
pregnancy.
•Physiological changes.
•Plasma volume increase by 50%.
•Red cell mass increase by 25%.
•Fall in Hb concentration and haematocrit
due to haemodilution.
•MCV increase secondary to erythropoiesis.

5. •Cont,
•MCHC remain stable.
•Serum iron and ferritin decrease because of
utilization .
•Total iron binding capacity increases TIBC
•Iron requirement increases total of 1000 mg in
whole pregnancy.
•Moderate increase in iron absorption .
•Folate requirement increases

6. •DEFINTION..
•WHO recommended that Hb concentration
should fall below 11gm/dl in pregnancy to
diagnose anemia.
•Incidence 30-50% pregnant women are
having anemia at pregnancy.
•90% have iron deficiency anemia .
•5% folate deficiency .

7. •CLINICAL FEATURE.
•Often asymptomatic.
•Diagnosed in routine screening .
•Other ,tiredness, dizziness ,fainting , pallor
may be apparent

8. •SCREENING .
•Routine screened by Hb concentration at
the beginning of pregnancy .
•It is cheep and simple..
•It does not reveal the cause .

9. •IRON DEFICENCY ANAEMIA .
•It is microcytic hypochromic . Reduced
MCV . MCHC.
•Etiology .
•Increase demand in pregnancy due to
expanding red cell mass, fetal requirement
.If iron stores are depleted because of
menstruation , recurrent pregnancy ,poor
intake , anemia develops rapidly

10. •CONSEQUENCES .
•Preterm labor.
•Infection
•Medical intervention during labor .
•Post partum blood loss.
•? IUGR.

11. •TREATMENT.
•Oral iron is effective when there is time .
•Hbincrease 0.8 g/dl per week
•Side effect depends on the amount of the
of the elemental iron .
•Choice depends on cost and patient
tolerance .

12. •Cont.
•Vitamin –C helps absorption .
•Main side effect are gastro intestinal ,
gastric upset and constipation .
•Indication for parenteral thereby .
•Lack of compliance , severe GIT side
effect, mal absorption
•Intera muscular iron sorbitol

13. •Cont.
•Deep imit is painful cause discoloration
of the skin .
•High level may be excreted before
utilization .
•IV IRON .
•Iron saccharatecause more rapid rise in
Hband has fewer side effect compared to
oral iron , but more invasive and need
admission to hospital

14. •Cont
•Blood transfusion
•Most rapid way to increase the Hb.
•Used when there is no time to correct
anemia especially when there is an
obstetrical problem eg, placenta previa
•Risks include allergy and transmission of
infection

15. •Cont.
•Prevention is possible with good balanced diet .
•Spacing pregnancies .
•Identification and treatment of iron deficiency
prior to pregnancy are optimal .
•Routine iron supplementation in pregnancy
improve in hematological indices.