1.51 CME

Management of Anemia in Pregnancy

Pembicara: Dokter Isha Rani

Consultant Obstetrics and Gynecology, Laparoscopic surgeon· Asarfi Hospital, Jharkhand

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Keterangan

In this case presentation, we explore a compelling instance of stroke, a medical emergency that demands swift intervention. Delving into the patient's history, symptoms, and diagnostic findings, we aim to unravel the intricacies of this cerebrovascular event. By examining the nuanced aspects of the case, we hope to shed light on the challenges encountered in stroke management, emphasizing the significance of early detection and comprehensive care in mitigating its potentially devastating effects.

Ringkasan

  • Anemia in pregnant women is a serious global health concern, with a high prevalence in India and a significant contributor to maternal mortality. Iron deficiency is the leading cause, and the severity of anemia is classified according to ICMR standards.
  • Normal hematological changes occur during pregnancy, including a significant increase in blood volume. While plasma volume increases more than red cell mass, it causes a dilutional effect on hemoglobin concentration known as physiological anemia. Adequate intake of erythropoietic factors like iron, folic acid, and vitamin B12 is crucial during pregnancy.
  • Clinical features of anemia range from asymptomatic to presenting with pallor, weakness, breathlessness, and swelling. A detailed history, including dietary habits and obstetric history, is essential for diagnosis. Investigations like CBC and peripheral smear are fundamental, with serum iron studies providing further insights.
  • Treatment of anemia focuses on prevention through improved diet and iron supplementation. WHO recommends daily oral iron and folic acid supplementation for pregnant women in developing countries. Drug therapy involves oral or parenteral iron administration, with newer compounds like carbonyl iron and ferric carboxymaltose showing promise.
  • Megaloblastic anemia, caused by folic acid and vitamin B12 deficiency, is also common in pregnancy. Diagnosis is based on red cell indices and peripheral smear findings. Treatment involves folic acid and vitamin B12 supplementation, with the route of administration depending on the severity of the deficiency.
  • Thalassemia is a genetic disorder of hemoglobin synthesis, with beta-thalassemia being the most prevalent form in India. Screening and genetic counseling are vital, especially if both parents are carriers. Management includes folate supplementation and blood transfusions, with careful monitoring for iron overload.
  • Management during labor requires extra precautions to minimize blood loss and prevent cardiac complications. Blood products should be readily available, and active management of the third stage is crucial. Postpartum contraceptive advice is essential to allow for replenishment of iron stores before subsequent pregnancies.

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