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Chapter-20 Anemia in Pregnancy

BOOK TITLE: Essentials of Obstetrics

Author
1. Hebbar Shripad
ISBN
9788184489095
DOI
10.5005/jp/books/11242_20
Edition
2/e
Publishing Year
2011
Pages
10
Author Affiliations
1. Kasturba Medical College, Manipal, India, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
Chapter keywords

Abstract

Anemia in pregnancy is a major health problem in developing countries. More than two-thirds of pregnant women in India are anemic and most of the times, it is due to deficiency of iron and folic acid. Study of anemia in pregnancy is important because it is directly or indirectly responsible for maternal deaths (20-30%) and it is associated with high perinatal loss. Anemic patients have poor tolerance for potential blood loss during delivery and are poor subjects for surgery. For this purpose, screening for anemia is routine in all antenatal clinics. According to World Health Organisation (WHO) 1975, the pregnancy anemia is defined as hemoglobin level below 11 gm/dl as this cannot be explained by physiological hemodilution that occurs in pregnancy. If this cut off value is considered, 40 to 80 percent of pregnant women in India and neighboring countries are anemic. It has been observed that the pregnant women in India do well when Hb percent is above 10 gm/dl and levels below this value may be accepted to consider them as anemic. For the purpose of management, anemia in pregnancy is arbitrarily classified as mild (8.7 to 10 gm/dl), moderate (6.6 to 8.6 gm/dl) and severe (6.5 gm/dl and below). There is increased incidence of PIH, abruptio placenta, preterm labor and puerperal venous thrombosis when pregnancy is complicated by anemia. Severe anemia (Hb%<6 gm/dl) needs blood transfusion especially nearing term. Most of the times, megaloblastic anemia responds to oral folic acid therapy.

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