Book of Medical Disorders in Pregnancy - Tintash

Chapter No: 1
Anaemia in pregnancy:
The increase in plasma volume causes
hemodilution in a pregnant woman
which can give artificially low haemoglobin.
The WHO advice that haemoglobin
levels should not fall below
11.0g/dl and certainly haemoglobin concentrations
of less than 10.5g/dl should
be regarded as abnormal.
When the hemoglobin falls below 10
grams per hundred milliliters of blood
during pregnancy, true anemia is said to
be present. A fall in hemoglobin level
without a concomitant fall in the mean
corpuscular hemoglobin concentration is
considered to be due to hemodilution.
But when reduction in hemoglobin as
well as mean corpuscular hemoglobin
concentration occurs, this is always due
to real anaemia.
Physiological hemodilution:
This can reduce the hemoglobin level to
as low as 80 per cent or 10 grams per
cent. The total mass of circulating
hemoglobin is not diminished by this
physiological dilution process. If the
bone narrow is provided with sufficient
amounts of iron.
It can then produce more red cells, and
hemoglobin will increase in proportion
to the increase in plasma volume. The
mass of circulating hemoglobin is
greater than in normal non pregnant
woman.
Whether this is advantageous to the
patient is not clear, but it appears to do
no harm, therefore iron supplementation
during pregnancy remains an accepted
ANAEMIA IN PREGNANCY
sound practice. The student is referred to
consult Chapter on nutrition in pregnancy
concerning value of routine iron
supplementation.
Mild anaemia