Hematology and Oncology Book

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Anemia in Pregnancy

Aka: Anemia in Pregnancy, Postpartum Anemia, Iron deficiency in Anemia in Pregnancy
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  1. See Also
    1. Anemia
  2. Pathophysiology
    1. Hemoglobin levels change during pregnancy
      1. Wanes in second trimester due to hemodilution
      2. Increases in third trimester
      3. Falls with delivery with placental separation
    2. Anemia in Pregnancy most often nutritional deficiency
      1. Folic Acid deficiency (Megaloblastic Anemia)
      2. Protein Deficiency (Malnutrition)
      3. Iron Deficiency Anemia
  3. Labs
    1. See Hemoglobin Cutoffs for Anemia
    2. See Iron Deficiency Anemia
    3. Hemoglobin Cutoffs
      1. First Trimester: 11 g/dl
      2. Second Trimester: 10.5 g/dl
      3. Third Trimester: 11 g/dl
  4. Management
    1. Hemoglobin 10 to 12 mg/dl
      1. Ferrous Sulfate 325 mg qd for 2 months
    2. Hemoglobin 9 to 10 mg/dl
      1. Ferrous Sulfate 325 mg bid for 2 months
    3. Hemoglobin 7 to 9 mg/dl
      1. Ferrous Sulfate 325 mg tid for 2 months
    4. Hemoglobin <7 g/dl
      1. Consider transfusion
    5. Hemoglobin <6 g/dl
      1. Transfusion to prevent adverse fetal outcome
  5. Prevention
    1. Prenatal Vitamins daily
  6. References
    1. (2008) Obstet Gynecol 112(1): 201-7

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