Anemia occurs in up to one third of women during the 3rd trimester. The most common causes of anemia are If women have a hereditary anemia (such as
sickle cell disease Sickle Cell Disease Sickle cell
disease is an inherited genetic abnormality of hemoglobin (the oxygen-carrying protein found in red blood cells) characterized by sickle (crescent)-shaped red blood cells and chronic... read more When anemia develops, the blood cannot carry as much oxygen as it normally does. At first, anemia causes no symptoms or only vague symptoms, such as fatigue, weakness, and light-headedness. Affected women may look pale. If anemia is severe, the pulse may be rapid and weak, women may faint, and blood pressure may be low. If anemia persists, the
following may result: The fetus may not receive enough oxygen, which is needed for normal growth and development, especially of the brain. Pregnant women may become excessively tired and short of breath. After delivery, the risk of infection in the woman is increased.
The bleeding that normally occurs during labor and delivery can dangerously worsen anemia in these women.
Blood tests
Anemia is usually detected when doctors do a routine complete blood count at the first examination after pregnancy is confirmed.
Treatment of the anemia
For severe symptoms or certain problems in the fetus, transfusions
Measures to correct anemia during pregnancy depend on the cause (see below).
Whether blood transfusions are needed depends on whether the following occur:
Symptoms, such as light-headedness, weakness, and fatigue, are severe.
Anemia affects breathing or the heart rate.
The heart rate pattern in the fetus is abnormal.
Not consuming enough iron in the diet (especially in adolescent girls)
Menstruating
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Having had a previous pregnancy
Women normally and regularly lose iron every month during menstruation. The amount of iron lost during menstruation is about the same as the amount women normally consume each month. Thus, women cannot store much iron.
Blood tests can confirm the diagnosis of iron deficiency anemia or folate deficiency anemia.
Anemia can usually be prevented or treated by taking iron and folate supplements during pregnancy. If a pregnant woman has iron deficiency, the newborn is usually given iron supplements. Taking folate supplements before becoming pregnant and during pregnancy reduces the risk of the baby having a neural tube defect.
A sudden, severe attack of pain, called sickle cell crisis, may occur during pregnancy as at any other time. The more severe that sickle cell disease is before pregnancy, the higher the risk of health problems for pregnant women and the fetus, and the higher the risk of death for the fetus during pregnancy. Sickle cell anemia almost always worsens as pregnancy progresses.
If given regular blood transfusions, women with sickle cell disease are less likely to have sickle cell crises, but they become more likely to reject the transfused blood. This condition, called alloimmunization, can be life threatening. Also, transfusions to pregnant women do not reduce risks for the fetus. Thus, transfusions are used only if one of the following occurs:
The anemia causes symptoms, heart failure, or a severe bacterial infection.
Serious problems, such as bleeding or an infection of the blood (sepsis), develop during labor and delivery.
If a sickle cell crisis occurs, women are treated as they would be if they were not pregnant. They are hospitalized and given fluids intravenously, oxygen, and drugs to relieve pain. If the anemia is severe, they are given a blood transfusion.
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