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Etiology: There Are 3 Main Causes: 1-Erythrocyte Production: (Hypo Proliferative Anemia)
Etiology: There Are 3 Main Causes: 1-Erythrocyte Production: (Hypo Proliferative Anemia)
CLINICAL FEATURES
Symptoms usually in severe anaemia
- Fatigue
- Giddiness
- Breathlessness
EFFECTS OF ANAEMA IN PREGNANCY
. Mother :
High output Cardiac failure (more likely if precelampsia
present. inadequate tissue oxygenation increase requirments
for excessive blood flow )
PPH
Predisposes to infection
Risk of thrombo-embolism
Delayed general physical recovery esp after c. section
Fetus: . IUGR
. Preterm birth
. LBW
. Depleted Fe store
. Delayed Cognitive function.
INVESTIGATIONS
Hb
Haematocrit
RBC Indices:
- Low MCV
- Low MCH
- Low MCHC
- Low PCV
Peripheral blood picture :
Microcytic Hypochromic anaemia .
INVESTIGATIONS
Serum iron decreased (<12 micro mol / l)
diuretic)
Exchange transfusion (Under cover of loop diuretic)
MANAGEMENT
Side effect of Fe Oral therapy:
. G. I upset.
. Constipation.
. Diarrhoea.
Parentral:
- skin discolouration
- local abscess
- allergic reaction
- Fe over load.
MEGALOBLASTIC ANAEMIA
Complicates upto 1% of pregnancies
Characterized by :
- RBC with high MCV
- White blood cells with altered morphology
(hypersegmented neutrophils).
Usually caused by :
- Folate deficiency may occur after exposure
to sulfa drugs or hydroxyurea
- Vitamin B12 deficiency
FOLATE DEFICIENCY ANAEMIA
At cellular level
Folic acid reduced to Dihydrofolicacid then
Tetrahydro-folicacid . (THF) e is required for cell
growth & division.
So more active tissue reproduction & growth more
dependant on supply of folic acid.
So bone marrow and epithelial lining are therefore
at particular risk.
FOLATE DEFICIENCY ANAEMIA
Folate deficiency:
- 0.5-1.0mg folic acid/day
If F/Hx. of neural tube defect
- 4mg folic acid/day.
Vitamins B12 Deficiency
It is rare
Occurs in patients with gastrectomy , ileitis, illeal
resection, pernicious anaemia, intestinal parasites.
Diagnosis:
Peripheral smear
ALPHA THALASSAEMIA:
Both heterozygous & homozygous forms exist.
Alpha thallassaemia trait.
HbH disease.
Alpha thallassaemia major.
SICKLE CELL SYNDROME.
Autosomally inherited .
Structural abnormality.
HbS - susceptible to hypoxia, when oxygen
supply is reduced.
Hb precipitates & makes the RBCs rigid &
sickle shaped.
Heterozygous----HbAS.
Homozygous-----HbSS.
Compound heterozygous---HbSC etc.
Sickle Cell Disease (SCD)