Anemia is the most common hematological disorder in pregnancy, affecting 50-60% of pregnant women. It can cause complications for both mother and baby, including preeclampsia, heart failure, preterm labor, and low birth weight. Treatment of anemia in pregnancy involves identifying the cause, oral or parental iron supplementation depending on severity and gestation, and blood transfusion if anemia is severe or the woman is in late pregnancy or labor. Managing anemia properly can help prevent complications.

2. • Most common Haematological
disorder in pregnancy
• WHO says 50-60% of antenatal
mothers
• WHO,1999,CDC 1990, Hb %
10g/dl
• Anaemia account 20 % of
Material deaths

3. Classification of
anaemia in pregnancy

4. Physiological anaemia
• Maternal plasma volume increases by 40 %
• RBC volume increases by 20%
• Dilution of whole blood
• Start from 6 week’s & goes to 32 week
• Mild anaemia

5. Causes of pathological
anaemia in pregnancy

6. During pregnancy

7. Investigation
• Degrees of anemia. Hb,RBC count,PCV.
• Type of anemia. MCV,MCH,MCHC,
• Causes of anemia
1. Examination of stool
2. Urinalysis
3. Bone marrow
1. No response
2. Hypo plastic anemia
3. L D Bodies

8. Complications of IDA in pregnancy
To Mother
During pregnancy
• Preeclampsia
• Infection
• Heart failure
• Preterm labour
During labour
• Uterine inertia
• PPH
• CCF
• HYPOVOLEMIC SHOCK
During puerperal
• Subinvoluion
• Puerperal sepsis
• Poor lactation
• DVT & Embolism

9. Effects on the newborn

10. • Supplementary iron therapy –
part anaemia prevention program
• Dietary advice – Food rich in iron
• Avoid teenage pregnancy
• Treatment of causes
1. Malaria
2. Worm infestation
3. Haemorrhoids
4. Dysentery
5. UTI

11. Specific therapy
• Oral iron
• PARENTERAL iron
• Blood transfusion

12. Iron therapy – oral
• Ferrus sulphate ,femorate , gluconate
• Elemental iron
• Treatment and prophylaxis
• Drawback- Intolerance,Nausea,
Vomiting,Diarrhoea,Constipation.unpredi
ctable absorption
• Response to therapy- sense of well being,
improved appetite,& outlook.
• Oral therapy – 12 weeks to 32 weeks

13. Parenteral iron therapy
• Indications- Failure of oral,or after 32 weeks
• Intravenous
• Iron sucrose ,sodium ferric gluconate, Ferric
carboxymaltose.
• TDI - Required iron dose (mg) = (2.4 × (target
Hb-actual Hb) × pre-pregnancy weight (kg)) +
1000 mg for replenishment of stores
• Limitation - Hb % raise take same time &
sensitivity

14. • Haemorrhage
• Severe anemia
• Refractory anemia
• Moderate anemia
after 36 weeks of
gestation

15. Management during labour
• Comfortable position in first stage of labour
• Oxygen inhalation
• Strict asepsis
• Cut short second stage of labour
• AMTSL
• Look for early signs of cardiac failure
• Lactation failure
• DVT
• Continue treatment of anemia

16. Summary
• Anemia in pregnancy is highly prevalent
• Treatment of preventble causes of anemia before pregnancy
• Symptoms of pregnancy mask anemia
• Treatment of anemia in pregnancy depends on degree of
anemia and gestation
• Blood transfusion is required in certain condition
• Specific precautions are required during delivery
• Correct anemia in puerperium