ANAEMIA IN

PREGNANCY
INTRODUCTION: IT IS THE COMMONEST
HAEMATOLOGICAL MEDDICAL DISORDER
IN PREGNANCY.
DEFINITI
ON
• HB LESS THAN 11g/dl BY WHO
• HB LESS THAN 10g/dl is acceptable in developing countries
INCIDEN
• ABOUT 70% OF WOMEN AT BOOKING CLINICS
• 40-80% IS THE DISTRIBUTION IN DEVELOPING COUNTRIES
• 10-20% IN DEVELOPED COUNTRIES
SIGNIFICA
• RESPONSIBLE FOR 20% OF MATERNAL DEATH
AETIOLO
• 1. NUTRITIONAL- IRON DEFICIENCY IS COMMONEST, OTHERS
ARE FOLIC ACD AND VITAMIN B12 DEFICIENCY.
• 2. INFECTIONS/ INFESTATION- MALARIA, UTI, URTI, AIDS
• 3. HAEMOGLOBINOPATHIES- SCDX, THALASEMIA
• 4. RBC CELLULAR DEFECTS- G-6-PD DEFICIENCY, SPHEROCYTOSIS
• 5. HAEMORRAGE- APH
• 6. APLASTIC STATES DUE TO RADIATION, DRUGS-
ASPIRIN, INDOMETHACIN
• 7. CHRONIC DISEASE- RENAL, LIVER, NEOPLASM
• 8. HAEMATOLOGICAL MALIGNANCIES- LEUKAEMIA, LYMPHOMA
CLASSIFICA
• MILD- LESS THAN 10G/DL
• MODERATE- LESS THAN 8G/DL
• SEVERE- LESS THAN 6G/DL
TYP
• 1. MICROCYTIC HYPOCHROMIC-FE-DEFICIENCY
• 2. NORMOCYTIC NORMOCHROMIC- BLEEDING, INFECTION,APLASIA
• 3. MACROCYTIC NORMOCHROMIC-MEGALOPLASTIC: FOLIC ACID
AND B12 DEFICIENCY.
CLINICAL

• SYMPTOMS-GENERAL MALAISE, EASY FATIGUABILITY,

PALPITAION, BREATHLESSNESS, GENERALISED SWELLING
SIG
• PALLOR OF CONJUCTIVA,TONGUE AND ORAL MUCOSA
• IMPAIRED NAIL BED FILLING
• TARCHYCARDIA
• CARDIAC MUMMURS
• RAISED JVP
INVESTIGATI
• FBC
• G6PD DEFICIENCY
• BLOOD FILM FOR MP
• PERIPHERAL BLOOD FILM
• SERUM IRON
• HB ELECTROPHORESIS
• STOOL MICROSCOPY FOR HOOKWORM OVA
• URINALYSIS FOR SCHISTOSOMA OVA
• COOMBS ANTIBODIES TEST TO ESTABLISH AUTOIMMUNE DISEASE
• LFT, E&U+CR
EFFECTS OF ANAEMIA ON
• REDUCES IMMUNITY TOINFECTIONS e.g UTI
• CONGESTIVE CARDIAC FAILURE
• SHOCK
• MATERNAL MORBIDITY AND MORTALITY IS INCREASED
EFFECTS OF ANAEMIA ON THE
• ABORTIN
• PRETERM LABOUR
• IUGR
• FETAL DISTRESS
• IUFD
• INCREASED PERINATAL LOSS
TREATMENT
• 1. GENERAL- IMPROVED NUTRITION, ANTIHELMINTHES AFTER 1 ST
TRIMESTERE.G MEBENDAZOLE500MG START OR 100MG B.D FOR
3DAYS
• 2. PRINCIPLE OF DEFINITIVE TREATMENT
• - DEGREE OF ANAEMIA
• -GESTATIONAL AGE
• ASSOCIATED COMPLICATIONS
• -HB 8-10G/DL AT LESS THAN 36WEEKS: GIVE FE/FA/MULTIVITAMINS
• - HB 8-10G/DL AT OVER 36WEEKS: GIVE FE,FA& MULTIVITAMINS
• HB LESS THAN 36 WEEKS
• ASYMTOMATIC- ORAL DRUGS , INFERON INFUSION
• SYMPTOMATIC-BLOOD TRANSFUSION, THEN ORAL DRUGS
• HB LESS THAN 6G/DL IRRESPECTIVE OF GA- BLOOD TRANSFUSION