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Chapter: Maternal and Child Health Nursing : Medical Conditions 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).

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.

 


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