Healthy bodies have adequate amounts of hemoglobin, the red blood cells that carry oxygen to cells. They also have an appropriate number of red blood cells. Anemia results when either there is too little hemoglobin circulating or there are too few red blood cells themselves. Due to the expansion of blood volume that takes place during a normal pregnancy, pregnant women are frequently found to be anemic. About 90% of the anemias occurring during pregnancy are due to iron-deficiency.

SIGNS AND SYMPTOMS

When anemia exists, carbon dioxide accumulates in the blood giving rise to the symptoms of anemia.

* dizziness
*pale mucous membranes
* always tired
* breathlessness
* palpitation and maybe a rapid pulse
* poor appetite

DIAGNOSIS

A complete blood count will separate the red cells and give a read-out for hemoglobin and hematocrit. The normal lab range for non-pregnant women is 12-16 g/dl and for the pregnant woman, 10-14 g/dl. The current standard definition for anemia is a hemoglobin below 11 g/dl. Pregnant women commonly have a decrease in their hemoglobin of about 10% due to the blood volume expansion.

CAUSES

Some causes of iron deficiency anemia:

* blood loss from profuse menstrual flow
* inadequate intake of iron, copper, folic acid, and B vitamins
* loss due to fetal intake
* hemorrhage
* insecticides
* drugs that destroy Vitamin E
* excess Vitamin K in pregnant women may cause anemia in fetus
* chronic use of laxatives
* malabsorbtion diseases - sprue, celiac
* cooking with large amounts of water
* eating large amounts of canned food

TREATMENTS

Prevention is important because many cases of iron deficiency anemia can be avoided through good nutrition and life style. For most types of anemia, supplementation of a ferrous product and/or folic acid will be given during the maternity period and postpartum as well as dietary guidance for ingestion of iron rich foods. In sever cases, blood transfusion may be necessary.

Treatment includes injections of Vitamin B12 and a very nutritious diet along with desiccated liver and supplementation with a B complex vitamin. Because folic acid can mask the effects of pernicious anemia, supplementation of this nutrient needs to be kept very small.