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ANAEMIA IN PREGNANCY

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ANAEMIA IN PREGNANCY AHMED ABDULWAHAB It is the commonest medical disorder of pregnancy. Physiological changes. Plasma volume increase by 50%. Red cell mass increase ... – PowerPoint PPT presentation

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Title: ANAEMIA IN PREGNANCY


1
ANAEMIA IN PREGNANCY
  • AHMED ABDULWAHAB

2
  • 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.

3
  • Cont,
  • MCHC remain stable.
  • Serum iron and ferritin decrease because of
    utilization .
  • Total iron binding capacity increases TIBC
  • Iron requirement increases total of 1000mg in
    whole pregnancy.
  • Moderate increase in iron absorption .
  • Folate requirement increases

4
  • 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 .

5
  • CLINICAL FEATURE.
  • Often asymptomatic.
  • Diagnosed in routine screening .
  • Other ,tiredness, dizziness ,fainting , pallor
    may be apparent

6
  • SCREENING .
  • Routine screened by Hb concentration at the
    beginning of pregnancy .
  • It is cheep and simple..
  • It does not reveal the cause .

7
  • 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

8
  • CONSEQUENCES .
  • Preterm labor.
  • Infection
  • Medical intervention during labor .
  • Post partum blood loss.
  • ? IUGR.

9
  • TREATMENT.
  • Oral iron is effective when there is time .
  • Hb increase 0.8 g/dl per week
  • Ferrous salt is better absorbed than the ferric
    form .
  • Side effect depends on the amount of the of the
    elemental iron .
  • Choice depends on cost and patient tolerance .

10
  • 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

11
  • Cont.
  • Deep im it is painful cause discoloration of the
    skin .
  • High level may be excreted before utilization .
  • IV IRON .
  • Iron saccharate cause more rapid rise in Hb and
    has fewer side effect. Compared

12
  • Cont
  • To oral iron but more invasive , need admission
    to hospital , it is true alternative to blood
    transfusion.
  • Blood transfusion ,
  • Most rapid way to increase the Hb .
  • Used when there is no time to correct anemia .
  • Risks include allergy and transmission of
    infection

13
  • Cont.
  • Prevention is possible with good balanced diet .
  • Identification and treatment of iron deficiency
    prior to pregnancy are optimal .
  • Routine iron supplementation in pregnancy improve
    in hematological indices.
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