Anemia During Pregnancy - The First Signs, Medications, Nutrition

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Anemia during pregnancy

What does anemia mean during pregnancy?

Anemia during pregnancy is characterized by a decrease in the level of iron in the body. This violation poses a danger to the health of the woman herself and her child. Their tissues and organs suffer from hypoxia. By this term, doctors mean oxygen starvation.

Anemia has four degrees of severity: mild, moderate, severe, and extremely severe. During pregnancy, iron deficiency, aplastic and hemolytic anemia are most common. Moreover, about 90% of all expectant mothers suffer from a lack of iron in the body. This violation can develop both independently and against the background of other pathologies.

If the level of iron in the body decreases, it affects the production of hemoglobin. The number of erythrocytes also decreases. This is how iron deficiency anemia develops in pregnant women.

If there is little hemoglobin and red blood cells in the blood, then the internal organs experience hypoxia. Iron in the body is not produced on its own, it enters it from the outside, with food.

In the 1st trimester of pregnancy, the woman's body does not experience an acute need for iron, since her menstruation stops, and the fetus is still too small to take large amounts of this trace element for her own needs. However, starting from the second trimester, the needs of a pregnant woman's body for iron increase and reach 4 g per knock.

Sometimes it happens that a woman had a history of latent iron deficiency anemia even before the time when she conceived a child. Then, starting from the first trimester of gestation, the expectant mother will suffer from a lack of iron. As statistics show, latent iron deficiency is observed in 60-80% of women. Therefore, it is so important to diagnose anemia even before the onset of pregnancy during the planning period. In this case, many negative consequences for the health of the mother and child can be avoided.

Content:

• What does anemia mean during pregnancy?
• Anemia in pregnant women according to microbiology 10
• Iron and its role in the human body
• Iron during pregnancy: how much does the body consume?
• Symptoms of anemia during pregnancy
• Causes of anemia during pregnancy
• Types of anemia in pregnant women
• Fetal anemia - what is it?
• Diagnosis of anemia during pregnancy
• Medicines for anemia during pregnancy
• Nutrition for anemia in pregnant women
• Prevention

Anemia in pregnant women according to microbiology 10

Anemia in pregnant women according to microbiology 10 has a code O99.0. These experts include anemia, which complicates the course of pregnancy and childbirth, as well as the postpartum period.

Iron and its role in the human body

Iron is an essential trace element that provides the vital functions of the entire body.

The role of iron is difficult to overestimate:

• Iron is a constituent part of hemoglobin, which transports oxygen to all organs and tissues.
• Iron is present in myoglobin. This protein is found in muscle tissue.
• The enzymes that are responsible for the synthesis of DNA and ATP contain iron in small doses.

It becomes clear that without iron, the body simply cannot exist normally.

Iron during pregnancy: how much does the body consume?

If a woman is not in position, then every day her body spends about 1 mg of iron. During menstruation, this figure increases to 2-2.5 mg per day.

For pregnant women, iron consumption is represented by the following values:

• Over the entire period of pregnancy, 220 mg of iron is consumed.
• 450 mg is spent on increasing the number of red blood cells in the body. During pregnancy, the volume of circulating blood increases by about a liter, which requires an increase in the level of all its elements.
• The fetus "takes" about 270 mg of iron for its needs.
• Another 90 mg of iron is required to form the umbilical cord and placenta.
• During childbirth, natural blood loss occurs. During this period, the body will lose another 200 mg of iron.

Thus, for the entire gestational period, about 1230 mg of iron is needed, so its need per day is 4.4 mg per day. If we compare the expenditure of iron by the body of a pregnant woman, then they increase 9 times compared to the expenditure of a woman's body at normal times.

Symptoms of anemia during pregnancy

Anemia in pregnant women may not manifest itself in any way, but only if it has a mild course. In this case, pathology can only be detected through a clinical blood test.

Common symptoms of anemia during pregnancy include:

• Increased fatigue.
• Frequent dizziness.
• Severe headaches.
• Blanching of the skin on an ongoing basis.
• Increased heart rate, which should not normally be felt.
• Fainting and light-headedness are possible.
• The woman becomes whiny, nervous, irritable. She constantly wants to sleep.

In addition to the general signs of anemia, this condition is also characterized by sideropenic syndrome.

Its manifestations are as follows:

• The skin condition worsens, it begins to peel off. Lack of iron leads to cracks in the skin.
• In about 20% of pregnant women, hair begins to fall out and the nail plates become brittle.
• Blood pressure decreases, heart rate increases.
• Shortness of breath can begin to bother both with physical effort and during periods of rest.
• Biting at the corners of the mouth is a common symptom of anemia. The mucous membrane of the mouth becomes inflamed, and ulcers may appear on the inner surface of the cheeks and on the gums.
• The mucous membranes of the stomach and intestines suffer, which leads to problems in the functioning of these organs.
• Often women in a position have a perversion of taste, there is a desire to eat unusual foods, for example, chalk or tooth powder. The sense of smell increases, there may be a craving for the smell of acetone, gasoline, paint, etc.
• Immunity decreases, which becomes the basis for easier penetration of infection into the body.
• The liver is impaired.

If one or more of the listed symptoms appear, it is necessary to consult a doctor and undergo appropriate studies. It is impossible to diagnose on your own.

Causes of anemia during pregnancy

As a rule, anemia in pregnant women develops in the second and third trimester, which is associated with an increase in the volume of circulating blood and the growth of the fetus.

Doctors regularly refer women to donate blood, which allows them to identify patients at risk. They are being monitored. If hemoglobin continues to decrease, then expectant mothers are prescribed prophylactic iron supplements. Also at risk are women who have chronic diseases of internal organs, for example, gastritis, hepatitis, pyelonephritis.

Anemia is a frequent companion of women who adhere to a vegetarian diet or diet. Also, a decrease in hemoglobin levels can be observed in patients who have previously undergone abortions, miscarriages, or suffer from bleeding.

With multiple pregnancies, the likelihood of developing anemia also increases.

The age of the pregnant woman matters. If a woman is less than 18 years old or more than 32 years old, then she is considered a risk group for developing anemia.

Sometimes it happens that a decrease in hemoglobin and red blood cells occurs for several reasons at once. In this case, the anemia will progress quickly and it will be difficult to cope with it.

Pregnant women at risk of developing anemia

There are many reasons that can lead to the development of anemia.

Therefore, special attention should be paid to women at risk:

• Women living in unsatisfactory socio-economic conditions. The worse the nutrition of the pregnant woman, the lower her hemoglobin level.
• Women who adhere to the principles of vegetarianism.
• Women who have previously been on a diet.
• Women who have had infectious diseases: pyelonephritis, viral hepatitis, dysentery.
• Expectant mothers with chronic diseases: tonsillitis, rheumatism, pyelonephritis, diabetes mellitus, gastritis.
• Women who give birth frequently. We are talking about women whose children are born more often than once in three years. In this case, the body does not always have time to fully recover. Therefore, the likelihood of developing chronic anemia increases. The iron deficiency will be completely closed 2 years after delivery.
• Women who have experienced anemia during a previous birth.
• Pregnant women under the age of 18.
• Pregnant women whose hemoglobin level drops below 120 g / l in the first trimester.
• Carrying two or more fruits at once.
• Polyhydramnios during pregnancy.

Types of anemia in pregnant women

In pregnant women, physiological (gestational) and true anemia are distinguished. Physiological anemia is also called physiological hemodilution, which is associated with an increase in plasma volume in a woman's body by 50%, and erythrocytes by 11%. Therefore, the red blood cells will be diluted with plasma, which naturally leads to a decrease in hemoglobin levels.

From the 20th week of pregnancy, all women are diagnosed with anemia. Sometimes this condition does not pose a threat to the health of the expectant mother and fetus, there is no need for treatment. However, the doctor must understand that it is precisely the values of one erythrocyte that should be evaluated: its volume and the hemoglobin content in it. If these indicators begin to decline, then we can talk about true anemia, which requires treatment.

It is worth noting that it is true anemias that are diagnosed in 90% of all pregnant women when the hemoglobin level inside each erythrocyte drops.

Depending on how much the level of hemoglobin in the blood decreases, there are 3 degrees of anemia in pregnant women:

• The first degree of anemia (mild form) - the hemoglobin level is 90-110 g / l.
• Second degree of anemia (moderate or moderate form of anemia) - hemoglobin level 71-90 g / l.
• The third degree of anemia (severe form) - the level of hemoglobin decreases to 70 g / l.

Fetal anemia - what is it?

Fetal anemia is a condition in which it receives less oxygen and begins to suffer from hypoxia. Chronic anemia is dangerous with multiple complications. First of all, this concerns intrauterine growth retardation, while during this period every day is important. Fetal growth retardation is observed in 32% of cases due to anemia.

After birth, the baby will also suffer from anemia. This condition is associated with the risk of the onset of premature birth, which is observed in 65% of cases. In the future, the baby will continue to lag behind in both mental and physical development, provided that the anemia remains undiagnosed and untreated.

The situation is aggravated by the occurrence of complications during labor, which may be too weak, a woman may experience massive blood loss, against the background of anemia, gestosis often develops.

After giving birth, a woman may not have milk, or it will begin to be produced in insufficient quantities, which will affect the health of the baby.

The consequences of anemia of a pregnant woman for the fetus:

• The likelihood of perinatal death increases.
• Hypoxia of the child's brain may develop.
• There is often a delay in the physical and mental development of the fetus.
• In 37% of cases, infectious and inflammatory processes develop in the child's body after his birth.
• Hypoplasia of tissues with underdevelopment of the amnion and chorion.
• Primary placental insufficiency.
• Asphyxia of the newborn during passage through the birth canal.

After birth, the child will suffer from anemia, which requires treatment. This condition is especially dangerous for premature babies.

Diagnosis of anemia during pregnancy

To establish that a woman has iron deficiency anemia, she will need to donate blood for a general analysis. A decrease in the concentration of hemoglobin in the blood is not always a sign that should be guided in the first place, since its fall may occur due to an increase in plasma volumes in the blood. However, you need to be concerned if the hemoglobin level is below 110 g / L in the first trimester of pregnancy, and below g / L in the second trimester.

To confirm his assumptions, the doctor will refer the woman for an extended blood test. It is imperative to examine the volume of circulating blood in the body, as well as the content of serum iron and hypochromia of erythrocytes. This will make sure that a particular woman actually develops anemia during pregnancy.

Medicines for anemia during pregnancy

Anemia during pregnancy requires long-term and complex treatment. Immediately after the start of taking the drugs, you should not wait for the effect, however, already on the 9-12th day, a jump of reticulocytes in the blood should occur. This will indicate that the treatment is correct. The fact that therapy has a positive effect is not a reason to stop it. It is possible to achieve a steady increase in the level of hemoglobin in the blood only 1.5-2 months after the start of treatment. Moreover, just raising the hemoglobin level is not enough, you need to fill the body's depot with iron. Therefore, taking iron supplements continues for several months. This is not a whim of the doctor and should not frighten the expectant mother.

If a woman has an early pregnancy and anemia is already observed, then most likely this pathology existed in her even before the moment of conception. In this case, it is strictly forbidden to postpone with therapy, since as the fetus grows and the volume of circulating blood increases, anemia will progress.

In addition to iron supplements, pregnant women are prescribed B vitamins, including folic acid and cyanocobalamin. Dose selection is carried out on an individual basis.

Proper nutrition is the key to getting rid of anemia, but recovery is impossible without taking medications. No more than 2.5 g of iron is absorbed from food per day, while it requires 2 times more.

For the treatment of women in position, the following medicines are used:

• Ferrous salts. A drug from this group is Aktiferrin. It can be purchased in solution, capsule and tablet form. The analogs of this drug are drugs called Totema and Hemofer.
• Ferrous salts, supplemented with vitamin C. The drugs in this group are: Ferroplex and Hemohelper.
• In the form of a solution, you can purchase the protein ferric succinylate, this drug is called Ferlatum.
• You can also take ferric iron preparations called Maltofer and Ferrum Lek.

Ferrous iron preparations penetrate into the body more easily, but have more side effects. First of all, this concerns the disruption of the functioning of the organs of the digestive system. Ferric iron preparations are less absorbed by the body, but side effects are much less common.

It is best to take iron supplements by mouth as capsules or tablets. Parenteral administration is practiced only in exceptional cases and in a hospital setting.

With intravenous infusions, the likelihood of developing the following side effects increases:

• Allergic reaction, which can be very serious, up to anaphylactic shock.
• DIC syndrome.
• Problems in the functioning of the digestive system.
• Formation of bruising and infiltrates at the injection site.

Nutrition for anemia in pregnant women

With the development of anemia, pregnant women need to make sure to adjust their diet. The menu should include meat. The best sources of iron are beef, veal, rabbit, chicken, and turkey. It is good to eat beef tongue. These products contain heme iron, which has a high bioavailability of 30%. The liver also acts as a valuable source of iron, but pregnant women should be cautious in their diet. This product is very high in vitamin A, which can have a toxic effect on the fetus.

In addition, the diet should be diversified with eggs, cheese, cottage cheese, fermented milk drinks. Fish, such as pink salmon and cod, are useful. Plant foods that are sources of iron are asparagus, apples, black currants, buckwheat, oatmeal. However, non-heme iron, which is found in plant products, is absorbed by the body only by 3-5%.

In general, the menu of the expectant mother should be varied. Indeed, in order for iron to be fully absorbed in the intestine, it needs other vitamins and microelements, for example, vitamin C. A child needs nutrients no less than a pregnant woman. Without this, its full development is impossible.

Protein is essential for building hemoglobin and muscle molecules. The best sources of protein are foods such as sour cream, cottage cheese, sea fish.

Menu option for a pregnant woman with anemia

First breakfast	Lunch	Dinner	Dinner
Two eggs and boiled fish	Vegetable cutlets	Baked meat with buckwheat	Vegetable stew and cheese
Fried liver and cheese	Boiled fish	Vegetable cutlets with yachts	Boiled meat and cottage cheese casserole
Boiled meat and vegetables	Rosehip infusion	Fried liver and pasta	Soft-boiled eggs and boiled fish
Choice of steamed cutlet and cereal	Boiled vegetables	Fried kidney and beetroot salad	Boiled meat and rosehip infusion

Eating correctly and in a balanced way should be started immediately after the woman has learned about her situation, despite the early gestation period. This will prevent the development of anemia and maintain health. In the first trimester, a woman's daily calorie content should be equal to 2700 kcal, where proteins and fats account for 80 g each, and carbohydrates - 320 g. In the second half of pregnancy, the calorie content can be increased to 3000 kcal. Although the specific numbers depend on how active the expectant mother is.

Prevention

WHO gives all women in a position an unambiguous recommendation: in the second half of pregnancy and during lactation, take iron supplements for prophylactic purposes. This will keep the level of hemoglobin in the blood normal and prevent anemia from developing.

For prophylactic purposes, the same drugs are prescribed as for the treatment of anemia, but in smaller doses. Starting from 12-14 weeks, you will need to take 1-2 tablets of iron-containing preparations. The course lasts from 14 to 21 days, after which it is necessary to take a two-week break and repeat the course again. For the entire gestational period, a woman will undergo about five such courses.

Also, with a preventive purpose, a woman's diet is being corrected, enriching the menu with animal products, fresh vegetables and fruits.

So, anemia in pregnant women is a condition that develops very often. You should not be afraid of him. You just need to closely interact with the observing obstetrician-gynecologist, take tests on time, eat right and follow all the doctor's recommendations. In this case, it will be possible to avoid health problems and make a strong baby.

The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist

Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.