| EFFECTS OF ANEMIA ON PREGNANCY |
- Mild anemia may not have any adverse effect on pregnancy and labor.
- Moderate anemia causes weakness, fatigue and poor work performance.
- Severe Anemia causes
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| EFFECTS OF PREGNANCY ON ANEMIA |
- Pregnancy aggravates any pre-existing anemia
- Severely anemic patients become symptomatic by the end of second trimester
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| RISK PERIODS FOR MATERNAL MORTALITY |
- 30-32 weeks of pregnancy
- During labor
- Immediately following delivery
- Puerperium (pulmonary embolism, cardiac failure)
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| IRON DEFICIENCY ANEMIA |
| Iron deficiency anemia has been defined as microcytic hypochromic anemia, when body iron store becomes inadequate for the need of normal erythropoiesis. Body iron store must be exhausted before red cell production is reduced; therefore, anemia occurs at a late stage of iron deficiency. Iron store depletion occurs as a result of an imbalance between normal physiological demands such as body growth, menstrual blood loss and pregnancy,and the level of dietary iron intake, the efficiency of iron absorption and utilization |
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| Rich Sources |
Liver, meat, poultry, fish, eggs, yolk, dry fruits, beans, green leafy vegetables, legumes, nuts, jaggery, apple, banana. |
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| Poor Sources |
Milk and milk products
- Although iron absorption is increased during pregnancy, the absorbed iron and the iron mobilized from stores are usually inadequate to meet the demands. Iron supplementation, therefore, becomes necessary during pregnancy especially in the non-industrialized countries.9
- The fetus obtains iron from maternal transferin regardless of maternal iron stores. The placenta traps maternal transferrin, removes the iron, and actively
- transports it to the fetus, mainly in the last 4 weeks of pregnancy.
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Factors affecting the iron status of a pregnant woman |
Iron absorption |
Iron loss |
Dietary iron (heme and nonheme) |
Physiological factors
Basal losses from desquamation from Intestines and |
| Enhancers of absorption |
skin |
Heme iron |
Menstruation |
Proteins |
Delivery |
Meat |
Lactation |
Ascorbic acid |
Pathological factors |
Fermentation |
Hookworm and other helminths |
Ferrous iron |
Hemorrhage from GIT |
Gastric acidity |
Allergies |
Alcohol |
Occult blood losses |
Low iron stores |
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Increased erythropoietic activity(high altitude, |
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hemolysis, bleeding) |
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| Inhibitors of iron absorption |
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Phytates |
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Calcium |
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Tannins |
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Tea and coffee |
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Herbal drinks |
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Fortified iron supplements |
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| TREATMENT |
| Prevention |
- Prophylaxis in non pregnant women
- Iron supplementation during pregnancy
- Treatment of worm infestation
- Improvement of dietary habits
- Improvement of sanitation and personal hygiene
- Improvement of female literacy status
- Food fortification with iron.
- Reproductive interventions.
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| Curative Treatment |
General Measures
- Diet rich in iron, protein and vitamins is prescribed
- Treatment of the cause of anemia.
Specific Therapy
Principles
- To raise the Hb as near as normal
- To replenish iron stores.
Choice of Therapy (depends upon)
- Severity of anemia
- Duration of pregnancy
- Associated complications
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