Introduction
Anemia is a condition that develops due to low levels of hemoglobin < 10.5 g/dl. If you have anemia, your body does not get enough oxygen-rich blood which means your body parts unable to get enough oxygen via oxygenated blood, which results into tiredness, shortness of breath, suffocation & generalized weakness. Some people experience dizziness & heart arrhythmias.
Anemia is a condition that develops due to low levels of hemoglobin < 10.5 g/dl. If you have anemia,
your body doesnot get enough oxygen-rich blood which means your body parts unable to get enough
oxygen via oxygenated blood, which results into tiredness, shortness of breath, suffocation &
generalized weakness. Some people experience dizziness & heart arrhythmias.
There are many types of Anemia:
• Iron deficiency anemia
• Vitamin B12-deficiency anemia.
• Hemolytic anemia.
Anemia especially Iron deficiency anemia, is common during pregnancy. Pregnant women are at high
risk for developing anemia especially in second or third trimester.
Anemia in pregnancy is preventable and treatable but severe or untreated anemia in pregnancy can cause following complications:
•Preterm labour
•Increased blood loss during delivery
•Low birthweight
•Developmental delays in your baby.
Anemia is a condition that develops due to low levels of hemoglobin < 10.5 g/dl. If you have anemia,
your body doesnot get enough oxygen-rich blood which means your body parts unable to get enough
oxygen via oxygenated blood, which results into tiredness, shortness of breath, suffocation &
generalized weakness. Some people experience dizziness & heart arrhythmias.
There are many types of Anemia:
• Iron deficiency anemia
• Vitamin B12-deficiency anemia.
• Hemolytic anemia.
Anemia especially Iron deficiency anemia, is common during pregnancy. Pregnant women are at high
risk for developing anemia especially in second or third trimester.
Anemia in pregnancy is preventable and treatable but severe or untreated anemia in pregnancy can cause following complications:
•Preterm labour
•Increased blood loss during delivery
•Low birthweight
•Developmental delays in your baby.
Recommended Daily Amount of Iran, In Milligram (Mg):
14 to 18 years 27mg
19 to 50 years 27mg
BREASTFEEING:
14 to 18 years 10mg
19 to 50 years 9mg
Treatment for anemia depends upon the severity of deficiency. it may starts from iron supplements via
oral route & ends with IV iron therapy, if orally treatment is insufficient to meet the demands.
Symptoms:
Symptoms may develop upon the severity of deficiency:
• Weakness
• Fatigue
• Shortness of breath
• Palpitations
• Irregular heartbeat
• Dizziness & fainting
Diagnosis:
Iron deficiency anemia/ cobalamin deficiency anemia is treated according to hb & serum feritin level.
Treatment varies according to stages of pregnancy.
Treatment And Management:
Upon complaints doctors order for complete blood count & other diagnostic tests which include(
serum ferritin, Vit B12).
1st TRIMESTER:
If Hb> 7g/dl ruled out, (100-200mg) elemental oral iron. check for Hb rise>1g/dl at 2 weeks. if no response occured. B12 supplement & folate added with elemental iron.
2nd TRIMESTER:
If Hb< 7g/dl ruled out, run serum ferritin level. If ferritin > 30ug/dl occur (ferritin> 100 with T sat> 15%). If ferritin< 30ug/dl occur, IV iron therapy required for <36 week period of gestation.
3rd TRIMESTER:
Hb<7g/dl at <36 weeks, check serum ferritin level. If ferritin<30ug/dl occur,IV iron therapy required for <36 week period of gestation.
If Period of gestation >36 weeks, Urgent blood transfusion required.
Oral Iron Therapy:
Depending upon the type of preparation only 1-8% iron is absorbed from the available oral iron
preparation.
Maximum dose of iron absorption is only upto 160mg/day. Whereas recommended dose of elemental
iron in pregnancy is 100-200mg/day in the British guideline and 120mg/day in the WHO guideline.
In general, ferric salt (III) have greater GI tolerability than ferrous (II) salts at the cost of reduced iron
absorption.
Intravenous Iron Therapy:
Intravenous iron therapy includes high-molecular iron dextran which is no longer justified due to
multiple transfusions & comparatively low rise in Hb/ferritin, numerous other newer iron preparations
like iron-isomaltoside and iron- carboxymaltose which allow larger infusion of elemental iron to be
administered over a short period of time with high rise of Hb/ferritin.
