Anemia in Pregnancy

Clinical Description

Anaemia in pregnancy is defined as HB of less than 11g/dl, (severe anemia is HB less than 7g/dl at any gestational age).

Signs and Symptoms

• Fatigue
• Shortness of breath on exertion
• Headache
• weakness,
• heart palpitations
• dizziness
• Pallor of the skin and mucous membrane.

Investigations

• FBC or hemoglobin check if FBC not available
• MPs and MRDT
• Urine dipsticks, urine, and stool microscopy
• Peripheral blood film for hematology if at tertiary level.

Pharmacological

At Health Centre

If HB is < 8 g/dl or any complications, refer to the hospital

Prevention

• Provide all antenatal women with Ferrous Sulphate 325mg 12 hourly
• Advise on diet rich in green leafy vegetable, liver, fish, eggs, red meat
• To prevent hook worm, give Albendazole (400 mg stat)
• To prevent malaria, give 2 doses SP (three tablets each dose) 4 weeks apart, starting after quickening (16 weeks’ gestation)
• Advise to keep adequate interval between pregnancy > 2 years’ minimum
• All breastfeeding mothers should take iron supplements

At District Hospital

Prevention (as above in Health Centre)

• FBC and treat according to the result
• If HB is < 7g/dl especially if symptomatic, then blood transfusion
• Transfuse rapidly if anemia due to blood loss.
• Transfuse slowly and with diuretics if chronic anaemia. (To reduce risk of congestive cardiac failure due to sudden circulatory overload.)
• Treat with ferrous Sulphate/ folic po bd and recheck HB in 2 to 4 weeks.
• Treat malaria or schistosomiasis if indicated
• If Haemoglobinopathy (e.g., sickle cell anemia) is suspected, then refer