Anemia During Pregnancy

NURSE: RABAB QABOLI

DefinitionCausesSymptomsTypes of anemiaIron-deficiency anemiaFolate-deficiency anemia

Vitamin B12deficiencyPregnancy–related anemia Risk Factors for Anemia in Pregnancy Possible complications of anemia for the expectant motherComplications of anemia for babyTests for AnemiaTreatment for AnemiaNursing management

Objective:

Definition

Anemia is a decrease in the number of red

blood cells (RBC's) or

hemoglobin, resulting in a lower ability

for the blood to carry oxygen

to body tissues

Types of Anemia During

Pregnancy

Several types of anemia can develop during pregnancy. These include:

•Iron-deficiency anemia•Folate-deficiency anemia•Vitamin B12deficiency•Pregnancy–related anemia

Iron-deficiency anemia

This type of anemia occurs when the body doesn't have enough

iron to produce adequate amounts of hemoglobin. That's a

protein in red blood cells. It carries oxygen from the lungs to

the rest of the body.

In iron-deficiency anemia, the blood cannot carry enough

oxygen to tissues throughout the body.

Iron deficiency is the most common cause of anemia in

pregnancy.

Folate-deficiency anemia.

Folate, also called folic acid, is a type of B vitamin. The body needs folate to produce new cells, including healthy red blood cells.During pregnancy, women need extra folate. But sometimes they don't get enough from their diet. When that happens, the body can't make enough normal red blood cells to transport oxygen to tissues throughout the body.

Folate deficiency can directly contribute to certain types of birth defects, such as neural tube abnormalities (spina bifida) and low birth weight.

Vitamin B12 deficiency.

The body needs vitamin B12 to form healthy red blood cells. When a pregnant woman doesn't get enough vitamin B12 from her diet, her body can't produce enough healthy red blood cells. Women who don't eat meat, poultry, dairy products, and eggs have a greater risk of developing vitamin B12 deficiency, which may contribute to birth defects, such as neural tube abnormalities, and could lead to preterm labor.

Blood loss during and after delivery can also cause anemia.

Pregnancy–related anemia

Mild anemia during pregnancy is not uncommon because the amount of blood

in the body increases by 20 to 30 percent. The body’s iron and vitamin

requirements therefore increase in order to produce an adequate number of healthy red blood cells. This type of

anemia can typically be prevented with proper nutrition and iron intake during pregnancy. Additionally, a healthcare

provider may prescribe vitamin supplements to ensure adequate intake

of iron and folic acid.

All pregnant women are at risk for becoming anemic. That's because they need

more iron and folic acid than usual. But the risk is higher if

you:

Are pregnant with multiples (more than one child)

Have had two pregnancies close together

Vomit a lot because of morning sickness

Are a pregnant teenagerDon't eat enough foods that

are rich in ironHad anemia before you

became pregnant

Risk Factors for Anemia in Pregnancy

Risks of Anemia in Pregnancy

Severe or untreated iron-deficiency anemia during pregnancy canincrease your risk of having:

A preterm or low-birth-weight babyA blood transfusion (if you lose a significant amount of blood during delivery)

Postpartum depressionA baby with anemiaA child with developmental delays

Possible complications of anemia for the expectant mother

Difficulty in breathing, increased heart palpitations and feeling pain in the chest.

Disease and severe anemia that results from severe bleeding after birth may require a blood transfusion to the patient, and this in turn may bring complications for the mother.

Complications of anemia for baby

-Entry in the throes of early-Having a baby is small in size for the stage of pregnancy or low birth weight-Having a baby is suffering from low levels of iron-Infection during pregnancy

Tests for AnemiaDuring your first prenatal appointment, you'll get a blood test so your doctor can check whether you have anemia. Blood tests typically include:Hemoglobin test. It measures the amount of hemoglobin -- an iron-rich protein in red blood cells that carries oxygen from the lungs to tissues in the body.

Hematocrit test. It measures the percentage of red blood cells in a sample of blood.

If you have lower than normal levels of hemoglobin or hematocrit, you may have iron-deficiency anemia. Your doctor may check other blood tests to determine if you have iron deficiency or another cause for your anemia.

Even if you don't have anemia at the beginning of your pregnancy, your doctor will most likely recommend that you get another blood test to check for anemia in your second or third trimester.

Treatment for AnemiaIf you are anemic during your pregnancy, you may need to start taking an iron supplement

and/or folic acid supplement in addition to your prenatal vitamins. Your doctor may also

suggest that you add more foods that are high in iron and folic acid to your diet.

In addition, you'll be asked to return for

another blood test after a specific period of time so

your doctor can check that your hemoglobin and hematocrit levels are

improving.To treat vitamin B12

deficiency, your doctor may recommend that you

take a vitamin B12 supplement.

The doctor may also recommend that you

include more animal foods in your diet, such as:

meateggs

dairy products

Foods that are high in vitamin C can help your body absorb more iron. These include:citrus fruits and juicesstrawberrieskiwistomatoesbell peppers

Nursing management:

-Assessment of nutritional intake and status-Assess for fatigue, pallor, sore tongue, anorexia, nausea and vomiting, stomatitis, some signs of infection, and severe pain (due to veno- occlusive crisis-Observe and monitor hematologic laboratory results -Encourage client to eat foods high in iron and folic acid like green leafy vegetables, fish, meat, poultry, eggs, and legumes.

-Teach how to prepare food in order to minimize the loss of iron and folic acid (steaming with small amount of water)

-Encourage to take foods high in Vitamin C for iron absorption-Emphasize diet high in fiber and fluids to avoid

(constipation