Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Presented by:  Nadia Rouchdy Bsc Charge Nurse OutPatient Clinics SFHP
<ul><li>WHO recommendation: </li></ul><ul><ul><li>Hemoglobin should not fall below 11 gm/dL </li></ul></ul><ul><li>CDC – 1...
Objectives <ul><li>To find the associated factors in our pregnant anaemic patients,  in relation to </li></ul><ul><li>AGE ...
PHYSIOLOGY <ul><li>THERE IS AN INCREASE IN PLASMA VOLUME – by 28 weeks it has increased by 50%.  </li></ul><ul><li>THERE I...
FACTORS WHICH ARE KNOWN TO LEAD TO IRON DEFICIENCY ANAEMIA IN PREGNANCY  <ul><li>Increasing age </li></ul><ul><li>Increasi...
<ul><li>A diet low in meat/poultry </li></ul><ul><li>Taking Iron absorption - reducers (calcium/ caffeine) within 1 hour o...
ANAEMIC MOTHERS HAVE A HIGH  RISK OF: <ul><li>Morbidity from OB hemorrhage </li></ul><ul><li>Transfusion risk </li></ul><u...
THEIR BABIES HAVE A HIGH RISK OF  : <ul><li>Pre-term birth </li></ul><ul><li>Low birth weight </li></ul><ul><li>Low intell...
MATERIALS/ METHODS <ul><li>Type Prospective  </li></ul><ul><li>Population – pregnant patients following in SFHP ante-natal...
<ul><li>Sample – 180  </li></ul><ul><li>Randomly  selected and  interviewed by the  attending  Physician who completed the...
RESULTS
15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 Age 1.70% 15% 22% 23% 25% 13.90%
0 - 1 2 - 4 5 - 8 9 + 0-1 2 - 4 5 - 8 9 + Parity 28.30% 31.10% 38.30% 2.20%
Primagravida 1 - 2 Years 3 - 4 Years 5 + Years Pregnacy 14% 31.50% 34.30% 20.20%
None Primary Middle Secondary University or More Educ Level 3.90% 18.30% 12.80% 30% 35%
Late 2nd  Trimester & Above # of Weeks 62.78% 37.22% Pregnant on  First Visit
Weekly 5.56% 94.44%
Daily 68.33% 31.67%
Weekly 21.67% 78.33%
Yes NO 65.36% 34.64%
2nd Trimester 90% 10%
Iron Rx 38.20% 39.30% 18% 4.50% Compliance Always Sometimes Occassionally As Rx Miss 1/Day Take Never Take
Nausea/Vomiting Constipation &  20.4% 2.7% 39.8% 1.8% 0.9% 4% 0.9% 3.5% 25.7%
Conclusions <ul><li>Factors that DID NOT contribute to developing Anaemia are: </li></ul><ul><li>Parity </li></ul><ul><li>...
Factors that DID Contribute to  Developing  Anaemia Are: <ul><li>Age </li></ul><ul><li>Diet (Not Consuming Liver & Green V...
WHAT WE FOUND OF STATISTICAL  SIGNIFICANCE WAS: <ul><li>Women with a higher education level had a lower parity (p-value <0...
RECOMMENDATIONS <ul><li>Educate pregnant patients regardless of age, parity, education level or gestational age regarding:...
<ul><li>Taking Iron as Prescribed: </li></ul><ul><li>-  Having a routine to help in remembering to  take their IRON Tablet...
 
Upcoming SlideShare
Loading in …5
×

lawen mune mu

504 views

Published on

nursing symposium
may 10,2010

  • Be the first to comment

  • Be the first to like this

lawen mune mu

  1. 1. Presented by: Nadia Rouchdy Bsc Charge Nurse OutPatient Clinics SFHP
  2. 2. <ul><li>WHO recommendation: </li></ul><ul><ul><li>Hemoglobin should not fall below 11 gm/dL </li></ul></ul><ul><li>CDC – 10.5 gm/dL (North America) </li></ul>Definition
  3. 3. Objectives <ul><li>To find the associated factors in our pregnant anaemic patients, in relation to </li></ul><ul><li>AGE </li></ul><ul><li>PARITY </li></ul><ul><li>DIET </li></ul><ul><li>COMPLIANCE with medication (Iron) </li></ul><ul><li>in order to provide relevant patient education. </li></ul>
  4. 4. PHYSIOLOGY <ul><li>THERE IS AN INCREASE IN PLASMA VOLUME – by 28 weeks it has increased by 50%. </li></ul><ul><li>THERE IS AN INCREASE IN BONE MARROW RED CELL PRODUCTION – but not enough to compensate for the huge plasma volume increase. </li></ul>
  5. 5. FACTORS WHICH ARE KNOWN TO LEAD TO IRON DEFICIENCY ANAEMIA IN PREGNANCY <ul><li>Increasing age </li></ul><ul><li>Increasing parity </li></ul><ul><li>Pregnancy interval of < 2 years (at least 2 </li></ul><ul><li>years is needed to rebuild Iron Stores) </li></ul>
  6. 6. <ul><li>A diet low in meat/poultry </li></ul><ul><li>Taking Iron absorption - reducers (calcium/ caffeine) within 1 hour of meals or Iron tablets. </li></ul><ul><li>Caffeine reduces Iron absorption by 40-60% </li></ul><ul><li>Calcium reduces Iron absorption by 30-40% </li></ul><ul><li>Non-compliance with Iron Rx </li></ul>
  7. 7. ANAEMIC MOTHERS HAVE A HIGH RISK OF: <ul><li>Morbidity from OB hemorrhage </li></ul><ul><li>Transfusion risk </li></ul><ul><li>Post-partum infection </li></ul><ul><li>Thromboembolism </li></ul>
  8. 8. THEIR BABIES HAVE A HIGH RISK OF : <ul><li>Pre-term birth </li></ul><ul><li>Low birth weight </li></ul><ul><li>Low intelligence and behavioral problems </li></ul>
  9. 9. MATERIALS/ METHODS <ul><li>Type Prospective </li></ul><ul><li>Population – pregnant patients following in SFHP ante-natal clinics with a HB ≤ 10 gm/dl. (MO1 dependents) </li></ul><ul><li>Sickle Cell Anaemia /Thalassaemia patients excluded. </li></ul>
  10. 10. <ul><li>Sample – 180 </li></ul><ul><li>Randomly selected and interviewed by the attending Physician who completed the questionnaire, between Nov.2009 and March 2010 </li></ul><ul><li>Statistical analysis – SPSS – version. 17 </li></ul>
  11. 11. RESULTS
  12. 12. 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 Age 1.70% 15% 22% 23% 25% 13.90%
  13. 13. 0 - 1 2 - 4 5 - 8 9 + 0-1 2 - 4 5 - 8 9 + Parity 28.30% 31.10% 38.30% 2.20%
  14. 14. Primagravida 1 - 2 Years 3 - 4 Years 5 + Years Pregnacy 14% 31.50% 34.30% 20.20%
  15. 15. None Primary Middle Secondary University or More Educ Level 3.90% 18.30% 12.80% 30% 35%
  16. 16. Late 2nd Trimester & Above # of Weeks 62.78% 37.22% Pregnant on First Visit
  17. 17. Weekly 5.56% 94.44%
  18. 18. Daily 68.33% 31.67%
  19. 19. Weekly 21.67% 78.33%
  20. 20. Yes NO 65.36% 34.64%
  21. 21. 2nd Trimester 90% 10%
  22. 22. Iron Rx 38.20% 39.30% 18% 4.50% Compliance Always Sometimes Occassionally As Rx Miss 1/Day Take Never Take
  23. 23. Nausea/Vomiting Constipation & 20.4% 2.7% 39.8% 1.8% 0.9% 4% 0.9% 3.5% 25.7%
  24. 24. Conclusions <ul><li>Factors that DID NOT contribute to developing Anaemia are: </li></ul><ul><li>Parity </li></ul><ul><li>Education Level </li></ul><ul><li>Pregnancy Interval </li></ul><ul><li>Consumption of Animal Protein </li></ul><ul><li>Gestational stage at first visit </li></ul><ul><li>Timing of Starting Iron Therapy </li></ul>
  25. 25. Factors that DID Contribute to Developing Anaemia Are: <ul><li>Age </li></ul><ul><li>Diet (Not Consuming Liver & Green Vegetables) </li></ul><ul><li>Iron Absorption-Reducers (takingTea/Coffee/Dairy Products and Calcium Supplement with meals & Iron) </li></ul><ul><li>Iron Compliance </li></ul>
  26. 26. WHAT WE FOUND OF STATISTICAL SIGNIFICANCE WAS: <ul><li>Women with a higher education level had a lower parity (p-value <0.001) </li></ul><ul><li>Older women tended to eat more meat/ chicken (p-value = 0.018) </li></ul><ul><li>Contrary to our belief the majority of our patients came early for care and were started early on IRON Treatment (p-value=0.027) </li></ul><ul><li>Younger women (< 30 yrs) were more likely to forget to take their IRON Tablet (p-value =0.048) </li></ul>
  27. 27. RECOMMENDATIONS <ul><li>Educate pregnant patients regardless of age, parity, education level or gestational age regarding: </li></ul><ul><li>The dangers of anaemia in pregnancy </li></ul><ul><li>Diet - Eating a source of animal protein at least every other day </li></ul><ul><li>- Eating liver and molokia weekly </li></ul><ul><li>Avoidance of IRON Absorption -Reducers </li></ul><ul><li>- Not drinking tea/coffee/dairy products within 1 hour of meals </li></ul><ul><li>- Not taking the CALCIUM supplement together with IRON Tablet . </li></ul>
  28. 28. <ul><li>Taking Iron as Prescribed: </li></ul><ul><li>- Having a routine to help in remembering to take their IRON Tablet </li></ul><ul><li>- Avoiding constipation by increasing roughage containing foods & increasing fluid intake </li></ul><ul><li>- Avoiding nausea and stomach upset by taking IRON during their meals </li></ul><ul><li>Include information regarding Anaemia in Pregnancy in High School. </li></ul><ul><li>Physician should show the patient their hemoglobin result in order to increase their compliance with their Iron Rx. </li></ul>

×