This document discusses the importance of estimating hemoglobin levels during pregnancy to check for and manage anemia. Hemoglobin should be estimated initially and at 28 weeks to diagnose and treat anemia if present. Moderate anemia is defined as hemoglobin between 7-11g/dl and severe anemia is less than 7g/dl. If a pregnant woman is found to be anemic, she should start iron supplements and have her hemoglobin rechecked after 1 month, referring her to a higher facility if there is no improvement. Hemoglobin can be estimated in resource-limited areas using a simple and inexpensive color scale developed by the WHO.

1. Presented by-
Harsh Rastogi
M.Sc. Nursing 1st year
KING GEORGE’S MEDICAL
UNIVERSITY, LUCKNOW

2.  Estimation of the level of hemoglobin (Hb) is
essential for the following:
 To check for the presence of anemia &, if
present, to what degree.

3.  For the further management, prevention &/or
treatment of anemia, in so far as the
administration of iron-folic acid (IFA) tablets
is considered. If the anemia is severe, the
women may need referral for taking injectable
iron preparation or undergo a blood transfusion.

4.  For the diagnosis of postpartum hemorrhage
(PPH) in an anemic women, in whom a smaller
amount of blood loss is taken as PPH.

5.  Estimate the Hb levels of pregnant women at
the initial antenatal visit & again at 28 weeks.
The initial Hb level will serve as a baseline to
compare with the later results at 28 to 30
weeks. An Hb level below 11g/dl at any time in
pregnancy in considered to be anemia; an Hb
level of 7 to 11g/dl as moderate anemia & less
than 7g/dl as severe anemia.

6.  If the woman is found to be anemic, start her
on the therapeutic dose. Estimate the Hb level;
refer the women after 1 month. If there is no
rise in the Hb level, refer the woman to a
higher facility with a good laboratory
infrastructure & trained personnel to find out
the cause of anemia.

7.  The level of hemoglobin is estimated by using a
World Health Organization (WHO) approved.

9. 1. HEMOGLOBIN COLOUR SCALE-

10. 2. TEST STRIPS-

11. 3. STERILE GLOVES-

12. 4. BLOOD LANCET-

13. 5. ALCHOL SWAB-

14.  6. WASTE DISPOSAL BAGS-

15.  The hemoglobin color scale is simple, reliable &
inexpensive tool developed by WHO to screen
for anemia in the absence of laboratory-based
hemoglobinometry.
 The hemoglobin color scale comprises a small
card with six shades of red that represent the
Hb levels at 4,6,8,10,12 & 14g/dl. The device is
simple to use.

17.  Use only approved test strips.
 Add a drop of blood to one end of the test
strip, just enough to cover an aperture in the
color scale.

18.  Wait for about 30 seconds; then immediately
read by comparing the blood stain with the
color scale to find the best color match.
 If the blood stain matches with one of the
shades of red exactly, record the lower value.

19.  Discard the test strip after use. Wipe the back
surface of the scale at the end of each session
or if it becomes soiled during use.