Hemoglobin (Hgb) level below 11 gm /dl in the first and third trimesters of pregnancy and below 10.5 gm/dl in the second trimester of gestation. The causes are the same as in non-pregnant women. Iron demand is increased by a factor of 4-5 during pregnancy. Iron deficiency anemia is the most common kind of anemia in pregnancy.

Diagnosis Clinical: Nonspecific symptoms like weakness, dizziness, palpitation, shortness of breath. Physical examination may reveal significant pallor of the conjunctiva and other parts of the body.

Laboratory: Hgb < 11

Treatment: Depends on the severity of anemia

Non drug treatment:

Iron rich diet

Drug treatment:

Ferrous sulphate, 300 mg p.o. tid for 1-3 months.
(For S/E, C/I and Dosage forms,: see page 100)

PLUS

Folic acid, 5mg /day, p.o.
(For S/E and C/I,: see page 98)

Dosage forms: Tablet, 200 mg, 1 mg, 5 mg; Injection, 5 mg/ml in 1ml ampoule. Sustained release capsule, 150 mg dry ferrous sulphate and 0.5 mg folic acid

Severe anemia: Requires admission and blood transfusion in the presence of complications.

Prevention

• Avoid frequent childbirth
• Prevent hemorrhage during pregnancy & childbirth
• Advise on adequate nutrition
• Prevent malaria
• Treat hookworm infection
• Supplement iron/folic acid to all pregnant women