anemia in pregnancy
Terms in this set (24)
most common medical disorder of pregnancy
fatigue, weakness, malaise, pallor, dyspnea, anorexia and/or pica, edema, more susceptible to infection, may be asymptomatic.
hemoglobin normals for nonpregnant women- 12-16
hematocrit normals for nonpregnant women- 37-47%
pregnant women- hgb should be at least 10-11
depending on trimester and hct should be at least 34%
hemoglobin <11 or hematocrit <32% in first and third trimesters.
hemoglobin <10 or hematocrit <30% in second trimester
at higher altitudes (5000 ft), anemia-hgb <14
most common types of anemia
folic acid deficiency
iron deficiency patho
iron deficiency anemia is decreased oxygen carrying capacity of RBCs- heart attempts to compensate by increasing cardiac output.
iron deficiency primary goal
even with good nutrition almost all pregnant women will eventually become anemic if not taking an iron supplement.
iron deficiency maternal risk
increased risk of infection, postpartum infections, pre-eclampsia, hemorrhage complications.
iron deficiency neonatal risk
increased risk of growth restriction, small baby, prematurity, stillbirth, neonatal death.
iron deficiency treatment
iron therapy- 60-120 of iron
or 325/3x/day of ferrous sulfate.
teaching with oral iron- on empty stomach, take with vit c, not with tea, coffee or milk. may get black/green stools.
if oral iron is not tolerated- parenteral iron
folic acid patho
folate deficiency causes megaloblastic anemia
due to increased folic acid metabolism during pregnancy, pregnant women are at risk.
folic acid prevention/causes
prevention- adequate levels of folic acid prior to pregnancy. recommended intake- 0.4mg folic acid daily
causes- poor diet
folic acid maternal risk
susceptible to infection
at risk for hemorrhage
folic acid fetal/neonatal risk
neural tube defects
cleft lip or palate
at time of conception
folic acid treatment
1 mg folic acid daily plus iron supplements.
iron deficiency usually coexists with this type of anemia; therefore, the woman should also receive iron supplements.
sickle cell hemogloblinopathy incidence
approx 10% of african americans in North America have sickle cell trait and less than 1% have sickle cell anemia.
sickle cell patho
a recessive autosomal disorder in which the normal adult hemoglobin, hemoglobin A, is abnormally shaped or sickled.
primarily in people of african descent and occasionally in people of southeast asian or mediterranean origin
sickle cell symptoms
acute recurring episodes of tissue, abdominal and joint pain. women who have sickle cell anemia are at an increased risk for, and tend to become anemic during pregnancy.
sickle cell maternal complications
vaso-occlusive crisis, infections including nephritis, bacteriuria, and hematuria, pyelonephritis, renal failure, preeclampsia, congestive heart failure, complications with sickle cell trait- increased incidence of UTI
sickle cell fetal/neonatal complications
miscarriage, fetal death (during and immediately following an attack), increased incidence of SGA/IUGR, prematurity
sickle cell treatment
folic acid, prompt treatment of infections, prompt treatment of vaso-occlusive crisis.
folic acid supplements of 1.0 mg/day should be taken to maintain hemoglobin levels.
vaso-occlusive crisis can occur with dehydration and fever; therefore, maternal infection should be treated promptly. hospitalization during a crisis is important for rehydration with IV fluids; administration of oxygen, antibiotics, and analgesics; and monitoring fetal heart rate.
mediterranean or cooley's anemia
hereditary disorder- abnormal synthesis and insufficient amount of hemoglobin produced for the RBC's; complications- bone deformities due to excessive bone marrow expansion.
should have genetic counseling
homozygous form of the disorder
complicates pregnancy- increased incidence of preeclampsia, low birth weight, fetal death, and fetal distress due to hypoxia