وصف
Anemia is one of the most frequent complications related to pregnancy. Normal physiologic changes in pregnancy affect the hemoglobin (Hb), and there is a relative or absolute reduction in Hb concentration. The most common true anemias during pregnancy are iron deficiency anemia (approximately 75%) and folate deficiency megaloblastic anemia, which are more common in women who have inadequate diets and who are not receiving prenatal iron and folate supplements. Severe anemia may have adverse effects on the mother and the fetus. Anemia with hemoglobin levels less than 6 gr/dl is associated with poor pregnancy outcome. Prematurity, spontaneous abortions, low birth weight, and fetal deaths are complications of severe maternal anemia. Nevertheless, a mild to moderate iron deficiency does not appear to cause a significant effect on fetal hemoglobin concentration.
ملخص
- Anemia is a common disorder affecting a significant portion of Indian women, particularly pregnant women. The WHO defines anemia in pregnancy based on hemoglobin and hematocrit levels, while the ICMR focuses on both qualitative and quantitative aspects of hemoglobin. Anemia is classified into mild, moderate, severe, and very severe categories based on hemoglobin concentration.
- Nutritional deficiencies, malabsorption, and poor dietary habits are major contributors to anemia in women. Menstrual disorders also play a role. During pregnancy, the increase in blood volume, including both plasma and RBCs, leads to dilutional anemia.
- Additional iron, folic acid, vitamin B12, pyridoxine, and trace elements are required during pregnancy to meet the increased demands. However, other causes of anemia, such as acute or chronic blood loss, parasitic infections, repeated abortions, and genetic factors, should also be ruled out.
- Symptoms of anemia vary based on severity, ranging from asymptomatic in mild cases to facial puffiness and breathlessness in severe cases. Acquired forms of anemia include nutritional deficiencies, hemorrhage, and hemolytic forms, while inherited forms are primarily due to hemoglobinopathies and membrane defects.
- Assessment involves eliciting a detailed history, focusing on potential causes like infections, bleeding, or malabsorption. Dietary habits and menstrual and obstetric history are also important. Biochemical examinations, including complete blood picture and peripheral smear, aid in diagnosis.
- Investigations depend on the severity and type of anemia, as well as whether it's acquired or congenital. Peripheral smear helps identify cell abnormalities, while liver function tests and hemoglobin electrophoresis are conducted. Stool examination and bone marrow aspiration can also be performed.
- Treatment depends on gestation age and severity. Oral iron supplementation with ferrous sulfate, ferrous fumarate, or ferrous ascorbate is common, along with iron-rich foods and vitamin C. Intravenous iron is used when oral therapy is ineffective or not tolerated. Dosage is calculated based on weight and hemoglobin deficit.
- Untreated anemia can lead to maternal complications like heart failure and increased risk of pre-eclampsia, as well as fetal complications such as intrauterine growth restriction. Government initiatives aim to reduce anemia prevalence through iron therapy and promoting awareness.
- For hemoglobinopathies, iron supplementation is given if ferritin is low and hemoglobin electrophoresis identifies abnormal hemoglobin types. DNA testing is used to confirm thalassemias. It is crucial to prevent anemia through social programs, increased awareness, and appropriate therapies.
نموذج شهادة
حول المتحدثين
Dr Aruna Reddy
طبيبة أمراض النساء والتوليد ورئيسة قسم أمراض النساء والتوليد في مستشفى أومني كوكاتبالي، حيدر أباد
تعليقات
تعليقات
يجب عليك تسجيل الدخول لتتمكن من ترك تعليق.