II. Pathophysiology
-
Hemoglobin levels change during pregnancy
- Wanes in second trimester due to hemodilution
- Increases in third trimester
- Falls with delivery with placental separation
- Anemia in Pregnancy most often nutritional deficiency
III. Labs
- See Hemoglobin Cutoffs for Anemia
- See Iron Deficiency Anemia
-
Hemoglobin Cutoffs
- First Trimester: 11 g/dl
- Second Trimester: 10.5 g/dl
- Third Trimester: 11 g/dl
IV. Management
-
Hemoglobin 10 to 12 mg/dl
- Ferrous Sulfate 325 mg qd for 2 months
-
Hemoglobin 9 to 10 mg/dl
- Ferrous Sulfate 325 mg bid for 2 months
-
Hemoglobin 7 to 9 mg/dl
- Ferrous Sulfate 325 mg tid for 2 months
-
Hemoglobin <7 g/dl
- Consider transfusion
-
Hemoglobin <6 g/dl
- Transfusion to prevent adverse fetal outcome
V. Prevention
- Prenatal Vitamins daily