ANEMIA AT PREGNANCYANEMIA AT PREGNANCY

Tutik HarjiantiTutik HarjiantiSSubDiv.of Hematology & Medical OncologyubDiv.of Hematology & Medical OncologyDept.of Internal Medicine, Dept.of Internal Medicine, Medical FacultyMedical Faculty

Hasanuddin University Hasanuddin University

The Limit of Anemia at Pregnancy:

Anemia is a condition where the Hb < 10% under normal

The limit of anemia at a woman : Hb < 12 gr%The limit of anemia at a pregnant woman : Hb < 10 gr %

The limit of Anemia based on The limit of Anemia based on TrimesterTrimester Trimester I : 12gr/% Trimester II : 11gr/% Trimester lll : 10gr/%

The caused of Low Hb at a The caused of Low Hb at a pregnant woman :pregnant woman :

-The increase of body volume at a -The increase of body volume at a pregnant woman (The adding of pregnant woman (The adding of blood cell is not equal to the blood cell is not equal to the adding of plasm)adding of plasm)

Plasm 30%, Blood Cell 18%, and Plasm 30%, Blood Cell 18%, and Hb 19%Hb 19%

This matter gain profit:This matter gain profit:

- decrease the resistance of - decrease the resistance of periferperifer

- less the lost of zat besi at give a - less the lost of zat besi at give a birth (at the bleeding process)birth (at the bleeding process)

The Influence of Anemia at The Influence of Anemia at PregnancyPregnancy

1.1. AbortusAbortus

2.2. PrematurePremature

3.3. Old Partus because of inertia uteriOld Partus because of inertia uteri

4.4. Bleeding of post partum because of Bleeding of post partum because of atoni uteriatoni uteri

5.5. ShockShock

6.6. Decompentation kordisDecompentation kordis

Kind of Anemia at PregnancyKind of Anemia at Pregnancy

1.1. Deficiency iron AnemiaDeficiency iron Anemia

2.2. Megaloblastyc AnemiaMegaloblastyc Anemia

3.3. Hipoplastyc AnemiaHipoplastyc Anemia

4.4. Hemolytic AnemiaHemolytic Anemia

Deficiency Iron AnemiaDeficiency Iron Anemia

The most happenThe most happen Caused: less of nutrition, re-Caused: less of nutrition, re-

absorption disturbing, function absorption disturbing, function disturbing, increase at excretion.disturbing, increase at excretion.

Increase of need at Trm IIIIncrease of need at Trm III Every day necessity to a pregnant Every day necessity to a pregnant

woman in Indonesia: 17 mg/hrwoman in Indonesia: 17 mg/hr

Examination which needed Examination which needed to decide the diagnose :to decide the diagnose :

Side Blood MorfologySide Blood MorfologyMCV, MCH, MCHCMCV, MCH, MCHCRetykulocyte IntensityRetykulocyte IntensityAnother Lab based on the result Another Lab based on the result of the Lab aboveof the Lab above

Anamnesis based on the result of Anamnesis based on the result of the lab abovethe lab above

Management of Anemia at Management of Anemia at Pregnancy:Pregnancy:

Non medicamentosaNon medicamentosa*Eat much and protein, mineral and *Eat much and protein, mineral and vitamin vitamin

*Avoid drugs that influence *Avoid drugs that influence hematopoisis hematopoisis

MedicamentosaMedicamentosa

vitamin Fe,B12,Asam Folat, vitamin Fe,B12,Asam Folat, transfutiontransfution

THANK YOUTHANK YOU