Anemia in pregnant women is dangerous. Anemia during pregnancy - signs, treatment and consequences for the child. What to eat if you have anemia during pregnancy

This is a decrease in hemoglobin levels that occurs during gestation and is pathogenetically associated with it. Manifested by weakness, fatigue, dizziness, perversion of taste and olfactory preferences, cardiac pain, muscle weakness, paresthesia, damage to mucous membranes, changes in skin, nails, hair. Diagnosed using a general clinical blood test and laboratory testing of iron metabolism. For treatment, iron-containing drugs, folic acid, cyanocobalamin are used, and complex antihypoxic therapy is carried out according to indications.

ICD-10

O99.0 Anemia complicating pregnancy, childbirth and the postpartum period

General information

The existence of physiological prerequisites for the occurrence of gestational anemia (hydremia) makes this disease one of the most common types of pathology during pregnancy. Manifest forms of the disease with clinically pronounced symptoms in economically developed countries occur in 16-21% of patients; in developing countries their prevalence reaches 80%. At the same time, hidden (latent) iron deficiency, taking into account the completeness of the diet, by the end of pregnancy is observed in 50-100% of women. The predominant form of anemia of the gestational period is iron deficiency, diagnosed in 75-95% of cases. The relevance of timely detection of pathology is associated with high probability complicated pregnancy and the occurrence of hypoxic conditions against the background of a physiological increase in oxygen demand by 15-33%.

Causes of anemia during pregnancy

The insufficient content of hemoglobin and red blood cells in the blood of a pregnant woman is due to both factors directly related to gestation and previous diseases. According to the observations of specialists in the field of obstetrics, in most patients, gestational hydremia has easily explainable physiological causes such as:

Increased need for iron. Starting from the second trimester of pregnancy, more iron is required to adequately maintain the fetoplacental complex. This microelement is rapidly consumed by the growing fetus, enters the placenta, and is used to increase the total number of red blood cells circulating in a woman’s blood. By the beginning of the third trimester daily requirement pregnant woman in the gland is at least 4-6 mg, and at 32-34 weeks it requires at least 10 mg/day.
Physiological hemodilution. During pregnancy, the volume of circulating plasma increases by 40-50%, and the volume of erythrocyte mass by only 20-35%. This is due to the body’s increased need for iron and plastic substances, with insufficient supply of which the rate of erythropoiesis does not correspond to the rate of increase in BCC. According to WHO recommendations, the permissible hemoglobin level in pregnant women is reduced to 110.0 g/l, and hematocrit - to 33%.

A factor that aggravates anemia in the postpartum period is the physiological loss of up to 150 ml of blood during childbirth, each 2.0-2.5 ml of which contains up to 1 mg of iron. Experts also identify a number of pathological reasons, causing disease. A decrease in the volume of red blood cells (microcytic variant of anemia) with a corresponding drop in hemoglobin levels is observed in case of poisoning with industrial poisons (for example, lead), many chronic diseases (rheumatism, diabetes mellitus, peptic ulcer, gastritis, chronic infectious processes), sideroblastic anemia, thalassemia. This condition also occurs with iron deficiency, caused by insufficient meat in the diet and consumption of foods containing non-heme forms of the microelement (plant foods, milk and dairy products).

Normocytic anemia with a reduced content of normal red blood cells is more often observed with blood loss due to pathology of the placenta, chronic renal failure, hypothyroidism, hypopituitarism, autoimmune hemolytic form of the disease, inhibition of erythropoiesis in the bone marrow. The macrocytic type of anemia with an increase in the volume of red blood cells is characteristic of a deficiency folic acid and vitamin B12, acute myelodysplastic syndrome, liver pathology (hepatitis, cirrhosis), alcohol dependence, reticulocytosis. Additional factors risks are the low material standard of living of a pregnant woman, frequent births, multiple pregnancy, long breastfeeding with a short interbirth interval, complicated course of this pregnancy (severe early toxicosis with repeated vomiting, gestosis).

Pathogenesis

The mechanism for the formation of anemia during pregnancy is usually associated with an imbalance between the intake of iron into the body, especially in combination with a deficiency of protein, folic acid, vitamin B12, and their high consumption for plastic purposes. An additional link in the pathogenesis is the inhibition of erythropoiesis due to an increase in the concentration of estradiol and the accumulation of metabolites that have a toxic effect on the bone marrow. The situation is aggravated by immunological changes associated with the constant stimulation of the mother's body by fetal antigens, which increases anti-tissue sensitization. The results of pathophysiological processes are tissue, hemic and circulatory hypoxia with metabolic disorders and further accumulation harmful products exchange.

Classification

The optimal criteria for systematizing the forms of anemia in pregnant women are the concentration of hemoglobin in the blood and the element or substance whose deficiency led to the onset of the disease. This approach to classification makes it possible to more accurately predict possible complications and select a pregnancy management regimen. Modern obstetricians-gynecologists distinguish the following forms of gestational anemia:

By severity: according to the WHO classification, taking into account the level of hemoglobin, the disease can be mild (90-109 g/l), moderate (70-89 g/l), severe (less than 70 g/l).
By type of deficiency: the most common is iron deficiency anemia (it accounts for about 95% of the incidence rate); folate deficiency and B12 deficiency forms of the disease are less common.

Symptoms of anemia during pregnancy

Mild degrees usually occur latently. When the iron concentration decreases to less than 90 g/l, signs of hemic hypoxia (anemic syndrome proper) and iron deficiency in tissues (sideropenic syndrome) become noticeable. ABOUT possible development oxygen starvation is indicated by general weakness, dizziness, tinnitus, discomfort and pain in the precordial area, complaints of increased heart rate, shortness of breath during physical activity. The mucous membranes and skin look pale. The woman becomes irritable, nervous, inattentive, her memory decreases, and her appetite worsens.

Tissue iron deficiency is manifested by rapid fatigue, perverted taste (desire to eat plaster, chalk, clay, sand, minced meat, raw meat), thickening and fragility nail plates, dryness and hair loss, muscle weakness, urinary incontinence due to weakening of the sphincter apparatus. In some patients, the epithelial membranes are affected: cracks (“jams”) appear in the corners of the mouth, the mucous membrane becomes inflamed oral cavity, there are complaints of itching and burning in the vulva area. With moderate and severe anemia, a slight yellowness of the palms and nasolabial triangle is often observed, associated with impaired carotene metabolism due to iron deficiency, and a “blue” discoloration of the sclera caused by degenerative processes.

Complications

Anemia in a pregnant woman poses a direct threat to the baby. Perinatal morbidity with this pathology can increase up to 100%, and mortality - up to 14-15%. Due to fetoplacental insufficiency, fetal hypoxia is observed in 63% of cases, hypoxic brain injury is observed in 40%, and developmental delay is observed in 32% of cases. Almost a third of newborns are born with asphyxia. Deficiency of vitamin B12 and folic acid causes abnormalities in the development of the spine and nervous system(spina bifida, etc.). Children whose mothers suffered from severe or severe anemia during pregnancy have worse established respiratory function. In the postnatal period, they are more often stunted in height and body weight, and are more prone to developing infectious diseases.

Diagnostics

The key tasks of the diagnostic search for suspected anemia during pregnancy are to assess the severity of the disorder and timely identification of complications. Since in most cases anemia is iron deficiency, laboratory methods for determining iron and hemoglobin levels are the most informative for making a diagnosis:

General blood analysis. The hemoglobin content is less than 110 g/l. The color index is reduced to 0.85. The red blood cell count is below 3.5 x 10 12 cells/l. There are signs of microcytosis (a decrease in the diameter of red blood cells to less than 6.5 microns). In the morphological picture of erythrocytes, poikilocytosis and anisocytosis are possible.
Iron metabolism study. Serum iron level is less than 12 µmol/L. The total iron binding capacity of serum (TIBC) is increased to 85 µmol/l or more. The concentration of ferritin (less than 15 μg/l) and iron saturation of transferrin (less than 16%) are reduced. The latent iron-binding capacity of the blood (IBC) is increased.

To exclude B12-deficiency and folate-deficiency variants of anemia that occurs during pregnancy, serum levels of cyanocobalamin and folic acid are determined. Taking into account possible complications from the fetus, it is recommended to assess its condition over time using fetometry, cardiotocography, and phonocardiography. Differential diagnosis is carried out between in different forms diseases, hemoglobinopathies, anemization syndrome caused by complications of pregnancy, and extragenital pathology.

Treatment of anemia during pregnancy

The main goals of therapy in pregnant women with reduced hemoglobin are correction of iron deficiency, elimination of manifestations of hypoxia, stabilization of hemodynamics and metabolism. In case of moderate and severe anemia, special attention is paid to supporting the adequate functioning of the fetoplacental complex. The treatment regimen includes medications that allow:

Restore hemoglobin content. For iron deficiency anemia, oral administration of optimally high doses of iron in an easily absorbed divalent form is recommended. It is preferable to use depot preparations with a slow release of the element. Parenteral correction of anemia is carried out in case of intolerance to ferrous iron taken orally, impaired absorption of it by the gastrointestinal mucosa, aggravated gastric ulcer or duodenum. For more effective absorption of the microelement, it is prescribed ascorbic acid. WHO experts recommend supplementing iron supplementation with folic acid, which prevents the development of folate deficiency anemia. Cyanocobalamin deficiency is the basis for parenteral administration of vitamin B12.
Eliminate the consequences of hypoxia. To ensure an adequate supply of oxygen and nutrients to the fetus, various elements of the uteroplacental blood flow system are affected in a complex manner. To increase blood flow to the placenta, tocolytics are used to relax the uterine wall. Microcirculation can be improved with the help of angioprotectors and drugs that affect blood rheology. The administration of membrane stabilizers, anticosidants, and actovegin can increase the fetus's resistance to hypoxia. Antihypoxic therapy is usually used for II-III degrees of anemia complicated by fetoplacental insufficiency. If necessary, drugs are used to correct metabolic acidosis and improve the cardiac activity of a pregnant woman.

Antianemic therapy is usually long-term and allows red blood counts to completely normalize only after 5-8 weeks of treatment. To improve efficiency medicines Diet correction is required. It is recommended to supplement the diet with foods rich in iron: beef, veal, lean ham, pork, beef, chicken liver, fish. It is necessary to reduce the amount of food that impairs the absorption of iron: cereals, bran, soybeans, corn, tea, coffee, milk, carbonate, bicarbonate, phosphate mineral water. Almagel, tetracyclines, magnesium and calcium salts, which can aggravate anemia, are prescribed with caution.

Prognosis and prevention

Mild anemia, diagnosed in most pregnant women with reduced hemoglobin levels, does not pose a threat to the life of the mother and fetus. Timely correction of moderate and severe forms of the disease can significantly improve blood counts and prevent the development of complications. To prevent perinatal and maternal complications, it is recommended balanced diet, early administration of iron supplements to patients with a history of menorrhagia, a short interval between births, long-term lactation after previous births, and multiple pregnancies. Women with anemia should pay increased attention during childbirth to quickly identify and correct possible labor disturbances,

Anemia during pregnancy: symptoms, signs, consequences for the child, treatment, severity

Anemia affects more than 20% of all women of reproductive age in the CIS, from 20 to 40% of pregnant women and more than 25% of children. Latent (hidden iron deficiency) is observed in 50% of the population, in women it reaches 60-85%. Latent iron deficiency is when there are no symptoms of anemia, but serum iron levels are reduced.

Diagnosis and treatment of anemia are important even before pregnancy, so that the course of pregnancy occurs with the least possible consequences for the child, and.

Iron in the human body
Fe consumption in pregnant women
Prevalence of the disease
Anemia - what is it?
Why does it happen in pregnant women?
Anemia during pregnancy: symptoms
Fe deficiency stages
Types of anemia during pregnancy and their causes
Degree of anemia during pregnancy based on hemoglobin level
Consequences for the child
What is the danger of anemia in pregnant women during childbirth and the postpartum period?
Contributing Factors
Nutrition for anemia in a pregnant woman
- Foods High in Heme Iron
Treatment of anemia during pregnancy

The role of iron in the human body

The 3 most important functions of iron in the body not only of a pregnant woman, but of any person:

Iron is part of hemoglobin and, accordingly, ensures the transfer of oxygen to all cells.
Fe is part of myoglobin, a protein found in muscles.
More than 100 enzymes of the human body contain iron in microdoses. These enzymes provide vital metabolic processes, including the synthesis of DNA and ATP (adenosine triphosphoric acid).

Iron consumption in pregnant women

Outside of pregnancy, non-menstruating female body consumes about 1 mg of iron daily, taking into account menstruation - 2-2.5 mg.

Consumption during pregnancy:

220 mg during pregnancy;
450 mg to increase the number of red blood cells (blood volume increases);
270 mg – for fetal formation;
90 mg – for the formation of the placenta and umbilical cord;
200 mg – blood loss during childbirth.

In total, the body spends 1230 mg to ensure gestation, which is 4.4 mg per day. The need for iron during pregnancy increases 9 times.

Anemia prevalence

What is anemia

Anemia is a clinical and hematological symptom complex characterized by a decrease in the number of red blood cells and hemoglobin per unit volume of blood. The concept of anemia includes diseases of various natures, but most often they are associated with iron deficiency, and therefore are called iron deficiency anemia.

Causes of iron deficiency anemia

All causes of anemia can be divided into 3 groups:

Insufficient intake or increased consumption. These include dietary restrictions, vegetarianism, pregnancy and lactation, intensive growth and maturation, and active sports. At physical activity muscle tissue is damaged, followed by its restoration and growth. The formation of myoglobin, the building molecule of muscle protein, increases. And internal reserves of plasma Fe are consumed faster.
Malabsorption in the intestines. A sufficient amount enters the body, but does not enter the blood. Observed during resection of the stomach, intestines, gastritis with reduced secretion, dysbacteriosis, celiac disease and helminthic infestation.
Blood loss. This group includes: excessive menstruation, uterine bleeding, and , bleeding from gastrointestinal tract, hematuria, blood donation.

In practice, anemia that occurs for one reason is rare; usually there are 2 or more. During pregnancy, it is quite difficult to identify the cause of anemia, since many examination methods are prohibited or difficult. Therefore, it is important to be examined for anemia and treat the diagnosis at the stage. This will prevent the development severe conditions during gestation.

All of the following signs of anemia in pregnant women can be observed in any expectant mother, this suggests that iron deficiency is present to varying degrees during pregnancy, but the diagnosis of anemia can be made after a blood test.

pallor of the skin and mucous membranes;
weakness, increased fatigue;
tendency to faint;
muscle weakness, hypotension;
headache, tinnitus, dizziness;
excitement or depression;
dry skin and mucous membranes with difficulty breathing,
changes in nails, hair loss;
tachycardia, shortness of breath;
perversion of taste;
predisposition to infections.

Stages of iron deficiency in the body

Normal is when all blood parameters are within normal limits and there are no clinical manifestations.
Prelatent iron deficiency - there are no clinical symptoms or complaints, but iron metabolism indicators are at the lower limit of normal.
Latent deficiency – when iron metabolism indicators are impaired, reduced, but there are no manifestations. The main and more stable indicator of iron metabolism is serum ferritin, a protein that binds iron. This protein provides iron storage. When it decreases, the indicators of hemoglobin, hematocrit, the number of red blood cells and their volume, and the hemoglobin content in the red blood cell may remain at normal levels.

Anemia during pregnancy

In pregnant women, anemia occurs in two types:

Physiological anemia (gestational) or physiological hemodilution. Normally, during pregnancy, plasma volume and red blood cell volume increase. Moreover, this happens unevenly - the volume of plasma increases by 50%, and erythrocytes by 11%. There is a dilution of blood cells (cells) and hemoglobin dilution.

Anemia is a symptom complex characterized by a spectrum of clinical and hematological manifestations, including a decrease in hemoglobin levels in the blood and a general disturbance in a person’s well-being. Anemia of pregnant women is a specific syndrome that develops during gestation, that is, carrying a child, and leads to various conditions aggravating pregnancy. In most patients, anemia develops in the 2-3 trimester.

Lack of hemoglobin at 4-9 months of gestation is observed in 20-85% of women. The vast majority of patients have iron deficiency anemia; in more rare cases, folate deficiency or hematopoietic conditions occur, that is, caused by dysfunction of the hematopoietic organs.

Attention! The death rate of embryos and newborns as a result of anemia in pregnant women ranges from 4 to 20%. Moreover, congenital abnormalities in the development of infants in this case reach 17%.

Classification of anemia by severity

There are two main types of iron deficiency anemia:

general anemic - develops when the transport of oxygen by blood cells is impaired;
sideropenic – formed as a result of anomalies in the process of absorption of iron by the human body.

With the development of anemia, the patient is worried about weakness and drowsiness, attacks of dizziness, falling blood pressure and cephalgia. As the disease progresses, external manifestations of the pathology also appear: dry and pale skin, brittle hair and nails, the appearance of a bluish tint to the sclera, cyanotic lips and nails.

In addition, this pathology can manifest itself with nonspecific symptoms:

discomfort, irritation of the throat when swallowing food;
stomach ache;
stool disorders;
spasms in the calves;
tremor of the limbs.

Attention! In pregnant women, anemia has a detrimental effect on the functioning of the placenta and blood vessels that provide blood exchange between mother and fetus. With such a violation, the risk of miscarriage or premature birth sharply increases.

Why is anemia dangerous during pregnancy?

Anemia during gestation develops as a result of the fact that the volume of blood in a woman’s body increases rapidly, but the number of oxygen-carrying blood cells remains the same. A deficiency of red blood cells and, accordingly, hemoglobin leads to hypoxia of various organs and tissues, including the placenta. This condition is dangerous both for the pregnant woman herself and for the fetus. A mild degree of pathology often provokes toxicosis in the 2-3 trimester. Attacks of vomiting and aversion to food lead to nutritional deficiencies in the patient’s body and further worsening of anemia.

In addition, a deficiency of blood elements during anemia in pregnant women leads to a clotting disorder, which threatens bleeding during childbirth, disruption of labor and other abnormalities. In the postpartum period, the presence of anemia in a woman causes delayed lactation or a complete lack of milk.

Children whose mothers suffered from hemoglobin deficiency experience delayed growth and physical development, pale skin, and brittle bones. Often such newborns require additional rehabilitation and placement in an incubator - a special device with automatic oxygen supply.

Mild anemia

About 80% of women during gestation suffer from iron deficiency in the body. Most of them have mild or first degree anemia. This pathology does not pose a threat to the life of the mother or fetus, but requires the woman to follow a special diet to maintain normal level hemoglobin. This form of anemia is diagnosed when its amount is less than 110 g/liter. At the first stage, the symptoms of the pathology appear quite rarely.

Attention! A timely blood test can diagnose anemia at an early stage. That is why pregnant women need to regularly visit a doctor and undergo the necessary tests.

Lack of oxygen and deficiency of blood cells leads to general hypoxia of the woman’s body. Against the background of slow blood flow, the woman and child develop mild intoxication.

Clinically, this condition is manifested by the following symptoms:

slight intrauterine growth retardation;
the appearance of symptoms of toxicosis in the 2nd and 3rd trimester of gestation: nausea, vomiting in the morning, heightened perception of smells and sounds;
premature discharge of amniotic fluid;
low birth weight of the newborn;
weakness of labor, which leads to protracted labor and the development of fetal hypoxia;
lack of nutrients supplied through the placenta to the fetus;
weakened immunity of the newborn.

First degree anemia can be easily corrected and, with proper treatment, does not have a significant detrimental effect on the fetus. To increase hemoglobin levels, the specialist recommends that the patient visit the fresh air, adhere to principles rational nutrition and take vitamins and iron-containing drugs in small dosages, for example, Sorbifer, Totema.

Attention! In some cases, pharmacological agents containing iron can cause constipation. If stool is disrupted, it is recommended to reduce the dose of the medicine and introduce laxative foods into the diet: plums, decoction flaxseeds, beets.

Moderate anemia

Anemia of the second or moderate severity has a sharply negative impact on the condition of both the pregnant woman and the child. This condition is diagnosed when the hemoglobin content in the blood is 90 g/liter or less. The patient begins to experience constant weakness and drowsiness. She may experience pain in the abdomen of a pulling or aching nature. Often, it is precisely these symptoms that force a pregnant woman to seek advice from a specialist.

Attention! Hemoglobin deficiency of the second degree is subject only to drug treatment. It is not possible to correct the patient's condition by changing her diet.

When the hemoglobin concentration decreases to less than 90 g/liter, a disruption of blood flow in the vessels of the placenta occurs, and the child ceases to receive the necessary amount of nutrients and oxygen. Anemia causes dystrophy of the placenta, which can lead to premature aging, premature onset of labor and the development of bleeding.

In addition, the condition of the embryo is adversely affected by the process of intoxication developing in the woman’s body. This pathology rarely leads to fetal death, but can cause a number of different disorders that affect the development of the embryo:

disruption of the processes of formation of tissues and organs of the embryo;
deviations in the development of the nervous system;
delayed growth and development of the fetus;
poor mobility of the embryo;
placental insufficiency is a condition in which acute oxygen starvation of the embryo occurs, fraught with subsequent dysfunction of the central nervous system.

Since the fetus does not receive the necessary amount of oxygen and various substances for normal growth and development, after birth the child also experiences some health problems:

rapid loss of body weight in the first few days of life;
congenital anemia;
abnormalities in the functioning of the heart and blood vessels;
disruption of the respiratory system, development of pneumonia;
slow physical and intellectual development;
disorders of the nervous system, convulsive syndrome, epilepsy;
hypoplasia of internal organs;

It should be noted that some disorders can be detected immediately after the birth of a child, while others are diagnosed only during its development. It is often impossible to guess which pathologies may develop in children as a result of anemia. Such infants usually have a weakened immune system, which leads to the frequent occurrence of respiratory diseases, the development of infectious and inflammatory processes.

Attention! Treatment of moderate anemia requires the mandatory use of pharmacological drugs and regular medical supervision. Properly selected treatment can minimize the risks of complications for mother and child.

Severe anemia

The most severe anemia during gestation is third degree anemia. The patient has a hemoglobin level of less than 70 g/liter. A pregnant woman in this condition requires hospitalization and close supervision by specialists. A decrease in hemoglobin to such low levels is a threat to the health and life of both the patient and the fetus. If severe anemia is detected immediately before childbirth, then in most cases a caesarean section to avoid the development of profuse bleeding and death of the mother and child.

The presence of severe anemia in a pregnant woman leads to the development of the following complications during gestation:

threat of miscarriage;
premature contractions, rupture of water;
placental abruption;
acute oxygen starvation of the fetus;
stopping labor;
underdevelopment of organs and systems of the fetus, including the central nervous and cardiovascular systems;
severe malformations and developmental disorders of the fetus;
premature birth;
heavy uterine bleeding;
miscarriages.

Such severe anemia has an extremely detrimental effect on the health of the newborn. In infants, breathing disorders, convulsive seizures, impaired sucking reflex, gastrointestinal dysfunction and a number of other abnormalities are noted. During a clinical examination of the child, the doctor notes his small height and weight, and thinning of the skin. Most newborns in this case require the help of resuscitators.

Therapy for anemia of the third degree of severity includes the complex use of iron-containing drugs in tablets or injections, blood transfusions, drip administration of saline, etc.

Anemia of extreme severity in patients is diagnosed in a few percent of cases. This condition develops in women against the background of secondary pathologies: uterine or other internal bleeding, inhibition of the function of hematopoietic organs, serious illnesses and other disorders of the body. Pregnancy with this form of anemia cannot be maintained.

Anemia during gestation is one of the most common pathological conditions that occurs due to an increased amount of blood volume in a woman’s body and a lack of formed blood cells. With timely diagnosis, this disorder can be successfully treated and does not have serious consequences on the health and development of the child.

Video - Anemia in pregnant women

Video - Anemia during pregnancy

Video - Is a decrease in hemoglobin dangerous in a pregnant woman?

The lack of hemoglobin in a woman’s blood quite often goes unnoticed, without causing any symptoms. However, the consequences of anemia during pregnancy for a child can be fatal, which necessitates special attention to the blood parameters of gynecologists who observe the patient. The task of blood in the body of any person is to transport important nutrients, as well as bound oxygen, which supply cells with energy and “building” material (protein, fats and other components). A decrease in the concentration of oxygen in the blood, which is closely related to hemoglobin, reduces the rate of metabolic reactions in all tissues without exception.

It is worth noting an important feature regarding the “nutrition” of the fetus in the mother’s body. The blood of a pregnant woman and baby does not mix in the uterus. The blood flow of the unborn child, although not directly related to the blood flow of the mother, is due to a special organ - the placenta - the fetus can receive oxygen only from the mother’s blood.

This fact is often unknown to patients who deliberately ignore the supposedly slight decrease in blood hemoglobin levels. The hemoglobin level in a pregnant woman’s body should not fall below 110 g/l, provided other normal blood parameters are present.

Quite often, anemia in a pregnant woman can be detected only by chance, by conducting a general blood test for preventive purposes during the observation period at the antenatal clinic.

Expectant mothers should understand that their body and fetus are a single whole in every sense. From the pathophysiological point of view, everything that is bad for the health of the mother is likely to lead to even worse disorders on the part of the fetus. This leads to the following dangers for a pregnant woman when she develops moderate or severe anemia:

Oxygen deficiency in tissues and cells leads to activation chronic inflammation, as well as the processes of formation of connective tissue. In turn, a decrease in functional activity against the background of exacerbation of chronic pathology will lead to a very difficult pregnancy. Naturally, in addition to the health of the mother in such a situation, the growth and development of the fetus is sharply affected.
Anemia becomes a symptom of damage to the kidneys, liver, bone marrow, a consequence of severe toxicosis during pregnancy. In this case, the woman’s life is considered first, measures are taken to preserve her health, and the child’s condition does not play any role until the mother’s condition is completely stabilized.
Prolonged chronic bleeding from ulcers in the gastrointestinal tract, lungs due to hemoptysis due to infections or as a result of the threat of miscarriage, as well as premature placental abruption(bloody and spotting vaginal discharge is often mistaken for menstruation by women in early gestation) will lead to anemia. But in such situations, we are also primarily talking about the life and health of the mother, and not the fetus.

The following diseases are accompanied by anemia, in which pregnancy is completely contraindicated and must be terminated in the first trimester for medical reasons if the problem cannot be successfully solved:

Chronic severe iron deficiency anemia.
Any form of blood hemolysis.
Pathology of the bone marrow, leading to the aplastic form of the disease, as well as oncological processes in it.
Any form of anemia with concomitant thrombocytopenia.

Thus, severe anemia in a pregnant patient primarily poses a threat to her life, which in any case, with inadequate treatment, is fatal for the fetus.

What consequences can there be for the child?

For the unborn baby, who is entirely dependent on his mother while he is in her womb, anemia can provoke the following unwanted obstetric pathologies:

Fetal growth retardation syndrome. It occurs due to insufficient placental function, which is aggravated by a lack of hemoglobin in the blood. The outcome of such a pathology during pregnancy can be various disorders of the mental and nervous development of the child, his mental retardation in the future, etc.
The emergence of a threat of miscarriage at different stages of gestation. If proper obstetric care is not provided, such a pregnancy may end in spontaneous abortion.
Premature birth. Although modern medicine capable of giving birth to children born even in the most early dates and weighing about 1000 grams, health problems in such children often accompany them for the rest of their lives. This is an increase in the likelihood of developing cerebral palsy (infantile paralysis), various allergic reactions and reduced immunity, poor development and other disorders.
Phenomena of toxicosis during pregnancy, which leads to a deficiency of nutrients passing through the placenta to the fetus.

Thus, anemia in a pregnant woman is a sure path to placental insufficiency. It is this that becomes the pathogenetic factor causing the development of all of the above complications.

In general, anemia during pregnancy leads to a decrease in the body's resistance to external aggressive factors. environment, and internal hidden pathological processes that were compensated before the moment of conception and did not manifest themselves in any way in the woman.

Therefore, diagnosis of this condition is carried out regularly in the antenatal clinic during the period of observation of pregnancy until childbirth. Women are prescribed regular blood tests, which makes it possible to establish an accurate diagnosis of anemia, which does not manifest itself clinically for a long time. Next, the doctor will be able to prescribe a wider range of examinations for the patient in order to establish the true cause of this pathological condition and give recommendations on how to overcome it.

How to eliminate anemia during pregnancy?

Treatment of any form of anemia in a pregnant woman has its own characteristics. The fact is that prescribing a number of drugs during the period when a woman is carrying a child is impossible and contraindicated due to negative influence on the growth and formation of the fetus. On the other hand, restoring the normal level of hemoglobin in the blood, especially with severe anemia, is necessary in order to preserve the life and health of the mother. That's why Treatment of this condition and correction of red blood counts is carried out depending on the cause in the following ways:

Optimizing the nutrition of the expectant mother. Quite often, anemia during pregnancy is a condition caused by malnutrition and poor nutrition against the background of toxicosis or changes in eating habits. Proper diet, rich in iron, protein and other important nutrients, allows you to stop anemia within several weeks, without even resorting to drug therapy. But we are talking only about conditions borderline with the norm, and not about severe cases.
Iron supplements. They are a classic treatment for iron deficiency conditions that develop against the background of both a long-term improper diet and an increased need for such a substance by the human body. Naturally, pregnancy worsens the course of this condition and requires special replacement therapy. However, unlike the standard procedure for treatment with such drugs during pregnancy, it is necessary special care in terms of calculating the dosage and frequency of taking medications containing iron. Diet and properly prescribed doses of iron-containing drugs can relieve mild to moderate anemia within 1-2 months in expectant mothers.
Replacement blood transfusion. It is advisable to carry out for women with chronic blood loss, which is complicated by severe anemia or hemorrhagic shock of the 2-3rd degree. Naturally, such a radical measure to replenish the volume of hemoglobin and red blood cells is fraught with a number of complications in pregnant women, but, unfortunately, there are no alternatives.

Every woman should understand that during pregnancy and planning it, it is much easier to avoid and cure anemia than to deal with its consequences and severe forms.

What consequences can anemia during pregnancy have for the child? updated: March 22, 2017 by: admin

A pregnant woman often experiences the condition. During pregnancy, the need for iron increases. It is necessary for the placenta and fetus to grow and develop properly. The amount of iron is often on the borderline of normal and can lead to the subsequent development of deficiency.

Consequences of anemia in pregnant women, its danger to the unborn child

Anemia is a disease characterized by a low level of iron-containing protein hemoglobin in the blood. A decrease in the amount of this protein leads to hypoxia, which impairs the health of the growing fetus and its mother.

The consequences of such a state are always negative. Especially for the unborn child. Persistent anemia can lead to:

to oxygen starvation of the fetus (this inhibits its development and provokes various pathologies);
to toxicosis, which is very dangerous in the second half of pregnancy (it poses a real threat to the life and health of the fetus and its mother);
in the future (after birth), to low hemoglobin in the baby;
to many obstetric difficulties during childbirth;
to placental abruption;
to premature rupture of water and childbirth;
to severe bleeding.

The worst thing that can happen is a miscarriage or stillbirth. It is very important to take this deviation seriously and follow all the doctor’s recommendations.

Hemoglobin norms at different stages of pregnancy

Iron-containing protein transports oxygen to tissues. It is part of red blood cells. To fully supply the body with oxygen, a certain number of such cells is necessary.

Normal hemoglobin levels in a pregnant woman range from 110-140 g/l. They change with increasing gestational age:

in the first trimester (1-12 weeks) the normal range is 110-160 g/l;
in the second trimester (13-26 weeks) – from 108-144 g/l;
in the third trimester (27-40 weeks) - from 100-140 g/l.

When the hemoglobin level drops to the lower limits, this indicates the onset of the development of IDA.

Causes of anemia

A slight decrease in iron levels compared to pre-pregnancy levels is quite normal. Blood volume increases faster than the number of red blood cells. This condition is called hydremia and is not considered dangerous.

Anemia is not an independent disease and occurs in various diseases. In pregnant women, it develops for various reasons, the main ones being:

lack of essential microelements before pregnancy;
development of dysbacteriosis, especially in erased form;
liver diseases in which iron transport is disrupted;
psychological state: stress, nervousness, which can cause metabolic failures;
insufficient dietary iron intake;
multiple pregnancy;
rapid increase in blood volume (plasma);
transfer of part of the iron to the placental tissue and for fetal development;
large blood loss during childbirth.

Additional factors that contribute to the development of IDA are harmful effects toxic substances (in case of poor environment, work).

The presence of chronic diseases, especially disorders in the immune and endocrine systems, increases the risk of anemia.

Stages of anemia development

At the initial period of development of iron deficiency, the body mobilizes using its reserves. The absorption of the microelement in the intestine improves, compensating for the deficiency for a while. With time hidden form deficiency goes into the initial stage of anemia.

There are three main stages of IDA, which are classified according to severity based on the quantitative deficiency of iron-containing protein and hemoglobin level.

Data corresponding to each stage of anemia are presented in the table:

It is very important to know the level of hemoglobin, especially in the second half of pregnancy, when the fetus quickly gains weight and its oxygen needs increase.

Clinical symptoms of IDA directly reflect the severity and rate of development. At the initial stage, when mild stage, the signs may be almost invisible.

Due to activation internal systems and redistribution of iron reserves, the need for oxygen is ensured for some time.

When the more acute stage of iron deficiency occurs, symptoms appear. They increase with a further drop in the level of red blood cells.

In this condition, a woman may have:

increased heart rate;
feeling of squeezing in the sternum;
weakness throughout the body and increased fatigue;
insomnia;
feeling of a lump in the throat making it difficult to swallow;
dizziness and tinnitus;
dyspnea;
fainting;
malfunctions of taste buds (perverted taste);
decreased appetite and indigestion;
frequent urination.

A woman can observe these symptoms on her own. This is a reason to consult a doctor who will prescribe the necessary examinations.

Upon external examination, the following signs become noticeable:

muscle weakness throughout the body;
dry skin, flaking;
slight yellowness and pallor of the skin (in the nasolabial area);
fragility of nails;
cracks in the corners of the mouth (jams);
the appearance of angular stomatitis;
fragility and dryness of hair, increased hair loss;
itching and burning sensation in the vagina.

These signs appear due to tissue hypoxia, which directly indicates the presence of anemia.

Diagnosis of IDA during pregnancy, necessary examinations and tests

Anemia can be suspected by a woman's physical examination and general history. The appearance of signs of low hemoglobin is an indication for examination. The final diagnosis of IDA is made upon receipt of test results. Based on their indicators, the stage of anemia is determined.

donate blood in the morning, on an empty stomach (except in emergency cases);
the day before the test, do not eat fatty or fried foods;
have a good rest before the analysis (a full night's sleep is important);
Tell the laboratory technician if you are taking any medications.

The presence of IDA is indicated by blood examination data:

An increase in ESR, an increase in platelets and reticulocytes is also possible. Leukocytes will correspond to the lower limit of normal.

Additional diagnostic procedures include:

study of the biochemical composition of blood;
general urine analysis;
Ultrasound of the kidneys, thyroid gland and abdominal cavity (if a severe form is suspected);
taking a puncture and performing a biopsy (according to indications).

They may schedule consultations with specialists: nephrologist, gastroenterologist, phthisiatrician, endocrinologist, hematologist.

Treatment methods for iron deficiency anemia in pregnant women

The goal of therapy is to replenish the amount of iron and trace elements. It is necessary to carry out complex therapy that will eliminate the causes of iron deficiency. Treatment consists of several stages:

stopping the progression of the deficiency;
increasing iron reserves in the body;
maintaining normal levels throughout pregnancy.

If IDA is diagnosed, self-treatment is unacceptable. You should especially not take medications uncontrollably. All methods of therapy to increase hemoglobin levels should be prescribed by the doctor managing the pregnancy. This concerns traditional methods and dietary changes.

Treatment with drugs

For anemia, iron supplements are used. The duration of use and dosage are determined by the doctor, based on the condition of the woman and the fetus. The stages of development of IDA are also taken into account.

Medicines are prescribed in the form of tablets, pills or capsules. Use vitamin B12.

Maltofer. Chewable strips based on ferric iron.
Ferroplex. The composition of the medicine includes ferrous iron salts and ascorbic acid.
Aktiferin. A popular representative of ferrous iron. Produced in the form of tablets, syrup and capsules.
Gyno-Tardiferon. French preparation consisting of ferrous iron and mucoproteosis. This is a substance that provides a slow release of trace elements.
Ferlatum. Ferric iron solution.

The daily norm for the treatment of mild anemia is 60-100 mg of iron. In case of severe deficiency - 100-120 mg (in the form of iron sulfate).

To improve the absorption of the microelement into the blood, it is recommended to take ascorbic acid. You can take the tablets with juice containing vitamin C.

Many experts prescribe folic acid in combination with iron supplements.

A blood test will determine normal values only after 5-7 weeks.

The composition of the medicines includes B vitamins, folic acid, vitamin C.

When there is iron intolerance when taken orally, malabsorption or severe anemia, medications are administered enterally (injections intramuscularly, intravenously, abdominal cavity). For injections, ferric iron preparations are used. The dose is calculated using a special formula.

The best form of taking iron supplements is considered to be oral. She has much less side effects than injections.

Folk remedies for the treatment of IDA during pregnancy

Many folk recipes can be used both as maintenance therapy and for the prevention of iron deficiency anemia. Before using any traditional methods, you should consult a doctor to exclude contraindications and possible allergies to the components of the remedy.

With insufficient hemoglobin levels ethnoscience recommends:

Eat 100 g of boiled beets on an empty stomach.
Drink Birch juice(1 tbsp. 2 rubles per day).
Take 2 tbsp. l. squeezed beet juice. It should stand in the cold for a couple of hours.
Drink warm cabbage juice, 1/3 tbsp. half an hour before meals.
Take an infusion of a mixture of rose hips and chokeberry. Calculation – 2 tbsp. spoons for 1 tbsp. boiling water You can infuse it in a thermos. Drink 1/2 glass 2-3 times a day.
Dilute 1 tbsp. viburnum juice with a liter of water, add honey to taste. Take all day instead of water.
Brew with green tea and drink dried strawberry, viburnum and sea buckthorn leaves.

There are many recipes for increasing hemoglobin. They are different and need to be selected individually, taking into account the composition and possible reactions of the body.

Nutrition to increase hemoglobin levels

Special nutrition is an important component in the treatment of iron deficiency anemia. Increasing the intake of iron from food at the initial stage of anemia can normalize hemoglobin without taking medications.

Attention! Products that increase the manifestations of toxicosis and cause an allergic reaction are excluded from the pregnant woman’s menu.

The treatment diet includes foods with increased content iron and other trace elements (manganese, selenium, cobalt, copper). The diet is enriched with vitamins B and C.

IN daily menu include the following products:

cereal porridge (buckwheat, oatmeal, millet);
beef liver and brains;
cottage cheese;
lean beef;
sea fish, seafood;
green vegetables and salads (peas, cabbage, spinach, parsley);
legumes (beans, soybeans, peas);
potatoes, zucchini, pumpkin;
garlic and onion;
fresh fruits (apricot, melon, gooseberry, black grapes, pear).

Freshly squeezed fruit and vegetable juices made from several types of raw materials are very useful. It is recommended to drink an infusion of rose hips and sea buckthorn.

Red beets and pomegranate contain a lot of iron. It is recommended to drink beetroot and pomegranate juices. It is necessary to take into account the properties of these products: they have a strengthening effect, and beets have a laxative effect.

Very high levels of iron in the liver of animals (pork, veal). They are in first place in terms of the level of assimilation of this element.

Prevention of iron deficiency anemia in pregnant women

The primary measures to prevent anemia can be considered a timely determination of the level of hemoglobin in the body and identification possible reasons the appearance of anemia at an early stage.

There is a group at increased risk of developing IDA. It includes:

women with multiple pregnancies;
pregnant women with chronic diseases;
women who have given birth frequently (if the period between pregnancies is short);
blood donors;
women from low-income families (poor nutrition is expected).

In such cases, preventive therapy is carried out throughout the entire period of pregnancy, accompanied by regular monitoring of hemoglobin levels. Iron intake is continued after childbirth to replenish iron reserves.

According to the recommendations of specialists, preventive measures include taking iron supplements and folic acid. The effective daily dose is 60 mg of iron (ferrous) and 250 mg of folic acid. It is better to take combination drugs containing both components.

A good remedy for prevention would be, which is used to treat anemia, and taking vitamin drinks.

Hemoglobin levels during pregnancy should always be monitored by a doctor.

Video about anemia during pregnancy

IDA in pregnant women is explained in an accessible and popular way in this video:

The likelihood of developing iron deficiency anemia during pregnancy should not be underestimated. Prevention or treatment therapy not started on time can lead to irreversible consequences, because both future mom, and an unborn baby.