Anaemia in Pregnancy

Contrary to what most people believe, anaemia is not a sign of pregnancy. Rather, anaemia in pregnancy is a red flag sign.

Anaemia refers to the reduction in the oxygen-carrying capacity of the blood. This could be due to abnormalities of the oxygen-carrying pigment of the blood – known as haemoglobin – either in its structure, function or concentration. The core component of haemoglobin is iron. When iron concentration is low, the condition is called iron deficiency anaemia.

The concentration of iron normally decreases in the body during pregnancy because:
1. Your baby absorbs from you in order to build his own blood
2. There is expansion in the water content of your body and this leads to relative dilution (dilutional anaemia)

Dilutional anaemia can be further compounded by:

*Not taking your iron tonics regularly

*Not taking the correct dose of iron

*Taking other medicines that react with iron, therefore reducing the amount getting into your system. The commonest example element that chelates iron is calcium. If you are on calcium supplements, you need to take it at a different time to avoid this. (Like, calcium in the morning, iron at night)

*Taking iron along with foods and drinks that reduce its absorption. Examples are milk, tea, coffee, etc.

To improve the absorption of iron, you should take it together with vitamin C or orange juice. Folic acid is also essential for iron to work effectively. It can be taken separately or as part of a multivitamin capsule.

To improve your body iron, you should eat foods that are rich in iron. Most especially, green leafy vegetables like spinach, kale, jute, etc.

It is worth mentioning that there are other underlying disorders that can cause, or complicate anaemia in pregnancy. Examples are:
-Sickle cell anaemia
-Thalassemia
-Kidney disease

Symptoms of anemia include:

*Fatigue
*Dizziness
*Paleness of the skin and mucous membranes
*Palpitations
*Shortness of breath
*Faintness or loss of consciousness
*Fetal growth restriction and low birth weight
*Sudden collapse and possibly, death

Any of these symptoms should warrant a  blood work up. This includes basic tests such as haemoglobin level, ferritin level, packed cell volume (PCV), and blood grouping and genotype.

The need for iron supplementation varies from trimester to trimester. In the first trimester, you don’t need to take iron, except in specific cases as determined by your doctor.

You may be able to get all your iron supplies from your diet alone. But the truth is that most women will need to take supplements. Only few women don’t need to take iron at all because of the risk of iron overload. For example, Sickle cell anaemia patients, who already have excess iron stores, should not take additional iron. Their anaemia is due to a different cause, therefore, they need blood, not iron.

The table below shows the reference haemoglobin levels according to trimesters:

Management of anaemia is straightforward after any underlying cause has been ruled out. Iron therapy is preferably administered by mouth. For those who can’t tolerate it by mouth (due to nausea or constipation), intravenous iron is a possible alternative. This is only done in a clinical setting, under close monitoring.
Severe anaemia in pregnancy can lead to cardiac failure if left untreated. In this case, blood transfusion is the treatment of choice.

©KT
2020

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