Normal pregnancy causes an increase in blood volume, which causes hemodilution. Although the number of red blood cells (RBCs) increases during pregnancy, the volume of plasma increases more, resulting in relative anemia. Many centers define anemia in a pregnant patient as a Hb value less than 10.5 g/dL, as opposed to the reference range of 14 g/dL in a non-pregnant patient. Anemia in pregnancy has two severity levels:
Mild anemia is normal during pregnancy due to an increase in blood volume
More severe anemia can put your baby at risk for anemia later in life.
Thrombocytopenia in pregnancy:
It is common, affecting approximately 7% of pregnancies. Platelet count less than 150,000/L or platelet count less than the 2.5th percentile for pregnant patients (116,000/L) is considered thrombocytopenia. There are three levels of severity for thrombocytopenia in pregnancy:
Mild thrombocytopenia is 100,000-150,000/μL
Moderate thrombocytopenia is 50,000-100,000/μL
Severe thrombocytopenia is< 50,000/μL
Anemia symptoms during pregnancy may include:
• Feeling tired or weak
• Progressive paleness of the skin
• Rapid heartbeat
• Shortness of breath
• Difficulty concentrating
Book an appointment with your gynaecologist right away if you experience any of these symptoms.
Thrombocytopenic patients are typically asymptomatic and have no prior history of thrombocytopenia.
There are several risk factors that can increase your chances of becoming anemic during your pregnancy:
• Have two pregnancies close together
• Are pregnant with more than one child
• Vomit frequently due to morning sickness
• Do not get enough iron
• Have a heavy pre-pregnancy menstrual flow
Inquire with your gynaecologist about your anaemia risk, and make sure you are tested at your first prenatal visit.
Current or previous bleeding problems, family history of bleeding, alcohol or substance abuse history, past obstetrical history, and transfusion history are all examples of medical history. The following are the most common causes of thrombocytopenia in pregnancy:
Pregnancy thrombocytopenia (70%)
Preeclampsia (21%)
Idiopathic thrombocytopenic purpura (3%)
Other (6%)
The most important factor in evaluating a pregnant patient with thrombocytopenia is clinical assessment.
Laboratory tests for diagnosing anemia:
• Hemoglobin test: determines the amount of hemoglobin present, with a diagnosis confirmed if values fall below the fifth percentile:
11 g/dL or less in the first trimester
10.5 g/dL or less in the second trimester
11 g/dL or less in the third trimester
Hematocrit test
The mean corpuscular volume (MCV), measured in fL, is the simplest way to differentiate anemias.
Other blood tests may be ordered by your gynaecologist to determine whether you have iron deficiency or another reason for your anemia.
Laboratory tests for diagnosing thrombocytopenia
A platelet count of less than 150,000/ μL (considered mild thrombocytopenia if the count is greater than 70,000/ μL).
Treatment for anemia:
In addition to your prenatal vitamins, consider taking an iron and/or folic acid supplement.
A vitamin B12 supplement to address a lack of nutrients.
Increase your consumption of animal items like meat, eggs, and dairy in your diet.
Treatment for thrombocytopenia:
• During the antepartum period, a periodic platelet count monitoring is done without any essential therapy, with labor and delivery to be decided by obstetric/maternal considerations. When the platelet count is > 80,000/μL and the platelet count is stable, epidural anesthesia is regarded as safe.
If you are pregnant or attempting to get pregnant, the greatest approach to prevent anaemia is through good diet.
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