Iron deficiency anemia in pregnancy

Iron deficiency anemia in pregnancy

Anemia in pregnancy is defined as hemoglobin concentration < 10 g/dl during pregnancy and puerperium.  

Introduction

The pregnant woman needs 1000 mg iron all through pregnancy i.e. a daily amount of 3.5 mg to maintain iron balance. The iron requirement in the latter half of pregnancy and for several weeks after delivery increases to about 6-7 mg/day.
It is the most common form of anemia encountered during pregnancy. The incidence is higher in poorly nourished women of low socioeconomic standard.

Causes

• Depletion of iron stores as occurs in non-supplementation of diet.
• Multifetal pregnancy
• Deficient absorption e.g. achlorhydria
• Bleeding with pregnancy or ankylostoma infestation 

Diagnosis

Symptoms

• Weakness, loss of concentration
• Headache and loss of appetite
• Dyspnea and palpitations 

Examination

• Pallor (nails, lips, conjunctiva)
• Pulse: tachycardia and waterhammer pulse
• Cardiac examination: systolic murmurs
• Abdominal examination: splenomegaly 

Investigations

Complete blood picture shows a picture of hypochromic microcytic anemia:

• Low RBC count and hemoglobin 
• Color index and MCHC are decreased
• WBC and platelets are normal

Serum iron is decreased