Friday, 1 June 2012

IRON DEFICIENCY ANAEMIA IN PREGNANCY

Pregnancy is associated with increased physiologic activity in most instances and most of the organs return to prepregnancy status between the time of delivery and 6 weeks postpartum.The changes in haematologic system include increase in blood volume, red blood cell mass, leucocytes, platelets and clotting factors.During pregnancy the red blood cell mass is increased 33% and the erythrocyte volume is increased steadily whether or not iron supplementation is given but with iron supplementions ,the increase in erythrocyte volume is greater.Since plasma volume also increases earlier in pregnancy and faster than RBC volume the haematocrit values may fall until the end of second trimester when the increase in RBC volume synchronises with the plasma volume increase.With the increase in RBC, the need for iron naturally rises and if the iron intake is not increased ,iron deficiency anaemia will result.In the later half of pregnancy maternal iron requirements may reach 6-7mg/day.If the iron is not readily avialable the foetus uses iron from maternal storage thus the production of foetal haemoglobin is usually adquate even if the mother is severely iron deficient.Anaemia is one of the most prevalent nutritional deficiency problems affecting pregnant women.As per WHO criteria haemoglobin <11gm/dl is anaemia.

SIGNS AND SYMPTOMS :- A person may have following symptoms and signs.

1. Dyspnoea (shortness of breath) due to decreased oxygen carrying capacity.
2. Palpitations (awareness of heart beating)
3. Tiredness and lethargy (due to lack of energy)
4. Pale complexion.
5. Angular stomatitis (ulcers on the corners of mouth)
6. koilonychia (spoon shaped nails)
7.Pica (eating non-food items like clay etc.)
8. Hair loss.
9. Others.

DIAGNOSIS :-To diagnose iron deficiency anaemia three parameters are useful ,which include:-

1. Haemoglobin( Hb) .
2. Red blood cell count.
3. Hematocrit.
Apart from these other parameters like MCV (mean corpuscular volume may also be helpful to rule out other causes of anaemia.

TREATMENT AND PREVENTION :-
1. Early detection and management may prevent late complications.
2. Routine use of daily iron supplements (30mg/day) after twelth week of gestation.
3. Well balanced diet rich in iron (green leafy vegetables, beans ,nuts , meat etc.)
4. More severe cases may require aggressive therapy or even blood transfusion.

1 comment:

  1. Good: I can drop my iron pills down to twice a day. Blarg: have to keep taking them for six more months.

    Hemoglobin is 11.8 (up from 7.6; normal range is 13.5 to 17.5).

    Iron is at 38 (up from 18; normal range is 37-150 — might be wrong on that upper number).

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