Nutritional or Pathological Anaemia In Pregnancy

Nutritional or Pathological Anaemia In Pregnancy 

During pregnancy, approximately 1500mg of iron is needed for the increase in maternal hemoglobin (400-500mg) the fetus and placenta (300-400gm) replacement of daily loss through stools, urine and skin (250mg) replacement of blood loss at delivery (200mg). About 95% of pregnant women with anaemia have the iron deficiency type.

Causes

·              Reduced intake or absorption of iron as a result of iron deficiency in diet and gastro – intestinal disturba nces (as in morning sickness).

·              Withdrawal of iron by fetus

·              Folic acid deficiency resulting from haemolysis, malaria , hemoglobinpathy, inadequate intake ,malabsorption of folic acid

·              Excess demand due to multiple pregnancy, multiparty, chronic inflammation especially urinary tract infection.

·              Hemorrhage, antepartum or post partum hemorrhage, hookworm.

Signs and Symptoms

Mother

Pallor of mucus membranes

Lassitude (always tired) Fainting, Dyspnoea, Tachycardia and palpitations

Reduced resistance to infection – Puerperal sepsis Potential threat to life.

Fetus/Baby

Increase risk of abortion

Increased risk of intrauterine hypoxia and growth retardation Preterm birth, Low birth weight

Increased risk of perinatal morbidity and mortality

Management

·              Good ante-natal care

·              Intake of diet rich in iron, diet rich in protein, minerals and vitamins

·              Reduce workload and stress. Encourage rest

·              Early recognition and treatment for anaemia .

·              Drugs/medication

Ferrous sulphate – 200mg tab b.d or t.d.s

Ferrous gluconate  - 300mg tab 1.e 2 tab b.d

·              Blood transfusion might be given to treat severe anaemia.

·              Treatment for worm if present.