Signs of severe anemia in pregnancy

Signs and Symptoms of Anemia

Signs and Symptoms of Anemia

Anemia is a condition where there is a decrease in red blood cells in the body specifically the hemoglobin. The hemoglobin is the one responsible for carrying oxygen from the lungs to all parts of the body. Anemia may be due to an underlying condition that a person might have, or maybe the primary problem of the patient.

Anemia signs and symptoms can be seen physically when the patient is weak-looking or when they experience body malaise. Sometimes, because of the lack of oxygen in the body, the patient will experience dyspnea or difficulty in breathing especially when exerting an effort. However, in worse cases, palpitations may occur because of the increased cardiac output that compensates to the needed oxygen in the body. Thus when the patient is assessed, it is noted that the nail beds are pale as well as the skin color and mucosal lining (look at the back of the eye). But very reliable information that the patient has anemia is when the blood was withdrawn, a significant decrease of hemoglobin once the results are given.

Picture 1. Difference between normal blood and anemic blood

Image source. Adam Inc.

Picture 2. symptoms of anemia

Image source : wikimedia. org

Signs and Symptoms of Anemia in Children

Anemia can also happen in children. Most pediatricians will say that anemia is more of a symptom of a disease rather than the disease itself. Anemia in children may be due to conditions like infection, poor nutrition, medications taken and others. Usually, the Signs and symptoms of anemia in children is the same with the adults. But in children, their signs and symptoms are quite noticeable. For instance, children are usually irritable, they experience dizziness or vertigo, easily gets tires and lacks energy. Sometimes, in ladies who are experiencing menstruation, they may have amenorrhea or absence of menstruation or irregular menstruation.

When children are assessed thoroughly, the physician may notice some spleenomegly or hepatomegaly, pale mucosal lining and pale nail beds. The patient may present as tachycardic or increased heart rate and even impaired wound healing.

Usually, the physicians would treat children with anemia by changing the child’s diet, adding vitamins and minerals, blood transfusion (in severe cases), and resolving the underlying problem that leads to anemia.

Signs and Symptoms of Anemia in Adults

In adults, anemia may happen due to underlying problems. for instance, it can be due to active bleeding. This is one of the reasons why women experience anemia. Because of heavy menstruation, anemia may occur. Gastrointestinal ulcers can cause anemia there are stoma in the gastric lining wherein bleeding may occur. Other causes may be related to pregnancy, end-stage renal disease or chronic renal failure, heavy wound bleeding, poor nutrition and many others.

Signs and symptoms for anemia in adult can also be easily detected. Pail nail beds and late capillary refill (when the nail beds are pressed and the redness won’t lasts more than 3 seconds), rapid heart rate, shortness of bread, body weakness, headache, lack of energy which can lead to fainting, low blood pressure, sometimes, jaundice skin may also be noticed.

Signs and Symptoms of Anemia in Women

According to studies, there are about 400 million women that are affected with anemia. This is one of the most under-recognized and under-treated problems of women. There are more women affected with anemia than men because women are prone to dieting

Especially in women who are vegetarians that does not eat foods high in iron like spinach, liver and red meat. Also women experience menstrual cycle and they use contraceptives like IUD or intrauterine device that can aggravate heavy bleeding.

Signs and symptoms of anemia in women may include fatigue, dizziness, headache, sometimes having cold feet and hands, having pale complexion, delayed capillary refill, and having heavy menstrual bleeding. A woman can tell that her menstrual bleeding is heavy because their sanitary pads or tampons are always full to the point that they will need to change their sanitary pads at night. Along with these, there are blood clots notices their menstrual period will last longer than seven days.

Moreover, it is very important for women to know that the signs and symptoms of anemia in women is that this problem doesn’t happen overnight. The signs and symptoms develop gradually. Body weakness will be experienced everyday only that it may worsen as days pass by especially if the underlying cause of anemia is not treated.

Signs and Symptoms of anemia During Pregnancy

During pregnancy, anemia is one of the common problems women encounter. This happens because the hemoglobin demand is higher because of the growing fetus. Before pregnancy, the normal demand for iron is at 15 milligrams per day. However, during pregnancy, the need for iron is twice as much. The 30 mg of iron needed is not achieved by eating red meat every day. With that, there is a deficit in the needed iron which leads to anemia.

The typical signs and symptoms of anemia during pregnancy is when a pregnant woman experiences weakness, excessive fatigue, delayed capillary refill, pale complexion and mucosal lining. Palpitations and tachycardia, dizziness or lightheadedness may be experienced. Thus, a confirmation of a patient with anemia will be through blood samples when these women will have their pre-natal check-up. When taking their complete blood count, their hemoglobin is lower than usual. With that, the OB-GYNE will do the proper treatment of correcting anemia. Pregnant women should always remember that untreated anemia during pregnancy can lead to complications which can be fatal.

Severe Anemia Symptoms

Anemia can range from mild to severe. Aside from the pale skin, tachycardia or fast heartbeat, headache and body malaise, severe anemia symptoms would include cognitive problems like forgetfulness or memory loss, chest pains, loss of appetite, sore tongue, diarrhea and even weight loss.

Pernicious Anemia Symptoms

Pernicious anemia is also called the vitamin b12-deficiency anemia. Large and immature cells are the ones that circulate in the blood but do not act as blood cells. In adults, pernicious anemia symptoms are linked with nerve damage. Patients will experience numbness and tingling sensation on upper and lower extremities. Body weakness is also experience as well as their loss of body reflexes. The patient is also prone to fracture; as well as feeling out of balance, and have trouble walking. Neurological problems will also include confusion and depression.

Pernicious anemia also affects the gastrointestinal tract. The patient will feel nauseated, may have episodes of vomiting, bloating feeling, diarrhea or constipation and loss of appetite.

Iron deficiency Anemia Symptoms

Iron deficiency anemia is due to a lack of iron, an important mineral in the body that decreases the hemoglobin count. In patients with iron deficiency anemia, the patient may experience paleness of skin color, pale mucolsa lining, lack of energy and body malaise, swollen tongue and even pica (the desire to eat unusual substances and even dirt).

Sickle cell Anemia Symptoms

Anemia During Pregnancy

24.03.2016 Andrew Johns 1 Popular

Anemia in Pregnancy

During pregnancy the doctors closely watch indicators of hemoglobin in the blood of future mothers. Indeed, its deficiency means both the woman and her baby receive little oxygen. There are many reasons for the decrease of blood hemoglobin, but the results of analysis are not always the occasion to raise alarm and take drugs. The doctor will help to sort out a situation.

Causes of Anemia During Pregnancy

The reduction of the amount of blood hemoglobin is called anemia. Hemoglobin is a protein that transfers oxygen, it is contained in red blood cell – erythrocytes. Anemia is not an independent disease, but a syndrome, which can be found at the whole range of diseases.

During pregnancy even the hemoglobin rates of healthy women decrease insignificantly – it is connected with the fact that the volume of the liquid blood increases more strongly than the volume of blood cells in expectation of a child. This state is not a problem and is called hydremia.

A woman does not feel worse in case of a hydremia, the signs of shortage of micro elements and vitamins (brittle nails, hair, dry skin, faintness) are not shown, the extent and the shape of erythrocytes do not change and their content of hemoglobin remains in normal condition. Hydremia passes without treatment.

But sometimes future mothers get real anemia, when hemoglobin decreases too strongly. The anemia while pregnancy can stem from different causes: from problems with assimilation of iron in the intestine, from the strong vomiting because of toxicosis, from expectation of twins or a triplet. The risk of an emergence of this disease will be higher if the future mother has some chronic diseases (pyelonephritis, hepatitis, etc.).

What are the Dangers of Anemia to Pregnant Woman

The problem is that the disease provokes development of various complications. The risk of the miscarriages, premature birth is higher in case of anemia. And even, if the pregnancy terminates successfully, this disorder can affect the child health: children, whose mothers suffered from anemia while pregnancy, often have the ferrum deficiency.

Alarming Symptoms of Anemia

Sometimes anemia is not at all felt, therefore during pregnancy it is very important to regularly undergo medical blood tests. At the same time, it happens that the woman feels faintness, dyspnea, vertigo, she sometimes has syncopes.

Often women have changes related to iron-containing proteins deficiency in their organism: hair loss, brittleness of nails, formation of cracks in the corners of the mouth, yellowness of the skin on palms. By the way, the exotic food addictions during pregnancy, in particular, a desire to eat a chalk, rubbers, smell liquids with harsh odors can also indicate increase of anemia, therefore one needs to hasten to a doctor with an appearance of these strangenesses, but not to a stationery shop for another box of chalk.

Treatment of Anemia While Pregnancy

Of course, diet plays not the least role in treatment of the disease, but the widely prevalent tradition to pitch in "iron-containing" fruits and vegetables (apples, carrot, pomegranates) has few bases. The iron metabolizes from fruits and vegetables significantly worse, than from meat food, therefore one needs to keep an eye that diet would be rich in meat and byproducts.

It is important to remember that elimination of iron deficiency during anemia will fail only with help of food, therefore one needs to take drugs prescribed by your doctor. Fortunately, now there are many drugs which do not have harmful impact on a child. The drugs for treatment of iron deficiency anemia also contain different components reinforcing suction of this substance: ascorbic, amber acid and folic acid, fructose, cysteine.

It is not worth stopping the intake of drugs prescribed by the doctor immediately after general health improvement: notwithstanding, during pregnancy the woman's organism is exposed to increased loads, it is on the way to go through a labor with inevitable blood loss and to a long breastfeeding period – it all can cause relapse of anemia, therefore the specialists recommend to take drugs containing iron for a long while.

Severity of anemia classification (1, 2, 3 degree)

Anemia is the pathological changes in the blood associated with a reduction in hemoglobin concentration. Anemia is not an independent disease, hematological changes generated in connection with other injuries of organs and systems. Understanding the true causes of its occurrence determines the effectiveness of prescribed therapy and lasting results.

Anemia: what is it?

The first step is to determine the age norm of hemoglobin (Hb) in the blood. The lower threshold Hb depending on age (g/l):

  • At birth — 145 – 225;
  • Up to 2 months. — 140 – 90;
  • From 3 months. to 5 years — 100;
  • From 5 to 12 years — 115;
  • From 12 to 15 years — 120;
  • Adult males — 130 – 160;
  • Women — 120 – 140;
  • Pregnant — 110.

Anemia not only changes the amount of hemoglobin, but this figure is a key in diagnosis.

Classification of anemias

Incidence distinguish Hb anemia:

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  • 1 degree (mild) — a drop to 20% from normal levels (110 – 90 g/l);
  • 2 degree (moderate) — lower level at 20 to 40% (from 90 to 70 g/l);
  • 3 degree (severe) — reduction in Hb for 40% or more (less than 70 g/l).

The second important parameter is the blood — color index — the rate is 0,86 – 1,1. Depending on its fluctuations, distinguish anemia:

  • Normochromic — CPU in the normal range;
  • Hypochromic — CPU 0,86;
  • Hyperchromic — the CPU is above 1.1.

Another indicator of blood — reticulocytes are young red blood cells. Their normal level is in the range of 0.2 – 2%. Their number indicates the regenerative function of the bone marrow. According to the degree of fluctuations in the level of reticulocytes anemia is divided into the following types:

  • Regeneratory (aplastic) — young cells are absent, bone marrow is not producing reticulocytes;
  • Hyporegenerative — reticulocytes less than 0.5%, the bone marrow is unable to cope with the regenerative function sufficiently;
  • Nomorehistory (loss of blood) — reticulocytes normal;
  • Hyperelementary (hemolytic form) — increased reticulocytes more than 2%, is intensive reaction of the bone marrow.

No less important is the division of the types of anemias pathogenetic indicates the cause hematological changes. The following types of anemias:

  • Iron deficiency — deficiency of iron in the body (diet, towards vegan and errors in diet, lack of vitamins, especially vitamin group b, intestinal parasites, acute respiratory infections);
  • Hemorrhagic — provoked acute/chronic blood loss (surgery, trauma, intestinal/uterine bleeding);
  • Digampathana — formed in violation of hematopoietic function of bone marrow (reduction of all cell indices – red blood cells, platelets, leukocytes);
  • Hemolytic — excessive destruction of red blood cells, red cells live for at least 120 days (an autoimmune disease, the abuse of vinegar, some medications, lymphoma);
  • B12 deficiency — inadequate vitamin;
  • Palaeodiversity — lack of folic acid.

Anemia in pregnant women

Special attention is given to identifying the early signs of anemia in pregnancy. A pathological condition can not only impair health of the expectant mother, but also seriously affect the development of the fetus. Normal parameters of blood in pregnant women (in brackets-the data for the state outside of pregnancy):

  • Hemoglobin — 105 – 110 (120 – 140) g/l;
  • Erythrocytes— 3,00 – 3,5 (3,45 – 3,95)×1012/l;
  • Hematocrit— 33 – 35 (40 – 42) ‰;
  • Leukocytes— 5 – 15 (4 – 10) ×109/l;
  • Platelets — 150 (300) ×109/l;
  • ESR — 80 – 50 (13 – 26) mm/h;
  • Reticulocytes— 10 – 25 (5 – 10) ‰.

These differences are explained by the restructuring of the female body during pregnancy and programmed nature of preparation for childbirth. In addition, the increase blood volume leads to decrease in parameters of blood cells.

Most often in pregnant women diagnosed with iron deficiency anemia. The necessary amount of iron for the expectant mother is 3.5 mg/day. (in the normal state, it is sufficient to 0.6 mg/day). However, the maximum capacity of its absorption from food does not exceed 2 mg/day.

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The clinical picture

The outbreak of disturbances in the body at clinical picture. In prelatent stage, the body first consumes the deposited iron and then signals the amount of blood. Symptoms of mild anemia:

  • A change of taste (strong desire to eat salty/spicy, the desire to eat chalk, ashes, or land) and smell (the attractiveness of the odors of gasoline or paint);
  • Muscle weakness, fatigue;
  • Sudden attacks of sore throat;
  • Absent-mindedness, frequent headaches.

With the development of anemia aforementioned symptoms persist, join the following characteristics:

  • Fade hair fall;
  • Skin/mucous membranes pale and dry;
  • Pallor of the nails, their fragility.

Symptoms of severe anemia:

  • Dizziness and drop in a/d often leads to fainting;
  • Swelling of the feet;
  • Temperature to 37,2 ° C;
  • Muscle weakness often leads to urinary incontinence;
  • Shortness of breath, heart palpitations;
  • Violation of cyclicity of menstruation and volume of bleeding;
  • Frequent respiratory infections (a consequence of the failure of the immune system).

The patient often detected Zayed on the lips, legkoobratimy ribbed nails, massive hair loss, neposredna gray hair and greenish/gray skin.

Diagnosis is carried out by hemoglobin (level of mitigation), advanced study of blood, including the counting of reticulocytes. Also informative biochemical analysis:

  • The decrease in ferritin levels (normal 15 – 150 µg/l);
  • The fall in serum iron (<12 µmol/l for women and 13 µmol/l for men);
  • Reduction of glasnacardoch transferin (less than 16%);
  • Inflated figure, OJSC — total iron-binding capacity the ability of the serum (more than 86 umol /l).

This study indicates iron deficiency, it is also possible pathological changes of the shape and number of red blood cells.

Treatment of the disease depends on the severity of anemia and its causes. Therapeutic measures:

  • Power correction — the inclusion in the diet of veal and liver, peas/beans, carrots and beets, and grapes and pomegranates, foods rich in vitamin C (fish, poultry), and limit coffee and strong tea.
  • Vitamin therapy — group (the best product – the vitamin b complex), Vit. C and A, tablets of folic acid.
  • Eliminate iron deficiency — receiving food, the rate of up to 3 months. (Her husband, Ferrovie Forte, Totem, etc.).

Usually subject to the recommendations and oral prescribed drugs anemia of the first degree is eliminated within a month. Anemia of moderate severity often requires the use of injectable forms of vitamins and iron preparations. Treatment often requires repetition to achieve a lasting result.

Severe anemia requires more radical measures. At the forefront of saving the patient’s life and prevent irreversible changes. Particularly acute is the issue with stopping breakthrough bleeding when a large blood loss during surgery. When Hb is less than 50 and 40 g/l of appropriate infusion of blood and erythrocyte mass. Positive effect therapy with corticosteroids and anabolic steroids. The more serious the prognosis of aplastic anemia, for which treatment is often the only solution is a bone marrow transplant.

Anemia in Pregnancy

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When you’re pregnant, you may develop anemia. When you have anemia, your blood doesn’t have enough healthy red blood cells to carry oxygen to your tissues and to your baby.

During pregnancy, your body produces more blood to support the growth of your baby. If you’re not getting enough iron or certain other nutrients, your body might not be able to produce the amount of red blood cells it needs to make this additional blood.

It’s normal to have mild anemia when you are pregnant. But you may have more severe anemia from low iron or vitamin levels or from other reasons.

Anemia can leave you feeling tired and weak. If it is severe but goes untreated, it can increase your risk of serious complications like preterm delivery.

Here’s what you need to know about the causes, symptoms, and treatment of anemia during pregnancy.

Types of Anemia During Pregnancy

Several types of anemia can develop during pregnancy. These include:

Here’s why these types of anemia may develop:

Iron-deficiency anemia. This type of anemia occurs when the body doesn’t have enough iron to produce adequate amounts of hemoglobin. That’s a protein in red blood cells. It carries oxygen from the lungs to the rest of the body.

In iron-deficiency anemia, the blood cannot carry enough oxygen to tissues throughout the body.

Folate-deficiency anemia. Folate is the vitamin found naturally in certain foods like green leafy vegetables A type of B vitamin, the body needs folate to produce new cells, including healthy red blood cells.

During pregnancy, women need extra folate. But sometimes they don’t get enough from their diet. When that happens, the body can’t make enough normal red blood cells to transport oxygen to tissues throughout the body. Man made supplements of folate are called folic acid.

Folate deficiency can directly contribute to certain types of birth defects, such as neural tube abnormalities (spina bifida) and low birth weight.

Vitamin B12 deficiency. The body needs vitamin B12 to form healthy red blood cells. When a pregnant woman doesn’t get enough vitamin B12 from her diet, her body can’t produce enough healthy red blood cells. Women who don’t eat meat, poultry, dairy products, and eggs have a greater risk of developing vitamin B12 deficiency, which may contribute to birth defects, such as neural tube abnormalities, and could lead to preterm labor.

Blood loss during and after delivery can also cause anemia.

Risk Factors for Anemia in Pregnancy

All pregnant women are at risk for becoming anemic. That’s because they need more iron and folic acid than usual. But the risk is higher if you:

  • Are pregnant with multiples (more than one child)
  • Have had two pregnancies close together
  • Vomit a lot because of morning sickness
  • Are a pregnant teenager
  • Don’t eat enough foods that are rich in iron
  • Had anemia before you became pregnant

Symptoms of Anemia During Pregnancy

The most common symptoms of anemia during pregnancy are:

  • Pale skin, lips, and nails
  • Feeling tired or weak
  • Dizziness
  • Shortness of breath
  • Rapid heartbeat
  • Trouble concentrating

In the early stages of anemia, you may not have obvious symptoms. And many of the symptoms are ones that you might have while pregnant even if you’re not anemic. So be sure to get routine blood tests to check for anemia at your prenatal appointments.

Risks of Anemia in Pregnancy

Severe or untreated iron-deficiency anemia during pregnancy can increase your risk of having:

  • A preterm or low-birth-weight baby
  • A blood transfusion (if you lose a significant amount of blood during delivery)
  • Postpartum depression
  • A baby with anemia
  • A child with developmental delays

Untreated folate deficiency can increase your risk of having a:

  • Preterm or low-birth-weight baby
  • Baby with a serious birth defect of the spine or brain (neural tube defects)

Untreated vitamin B12 deficiency can also raise your risk of having a baby with neural tube defects.

Tests for Anemia

During your first prenatal appointment, you’ll get a blood test so your doctor can check whether you have anemia. Blood tests typically include:

  • Hemoglobin test. It measures the amount of hemoglobin — an iron-rich protein in red blood cells that carries oxygen from the lungs to tissues in the body.
  • Hematocrit test. It measures the percentage of red blood cells in a sample of blood.

If you have lower than normal levels of hemoglobin or hematocrit, you may have iron-deficiency anemia. Your doctor may check other blood tests to determine if you have iron deficiency or another cause for your anemia.

Even if you don’t have anemia at the beginning of your pregnancy, your doctor will most likely recommend that you get another blood test to check for anemia in your second or third trimester.

Treatment for Anemia

If you are anemic during your pregnancy, you may need to start taking an iron supplement and/or folic acid supplement in addition to your prenatal vitamins. Your doctor may also suggest that you add more foods that are high in iron and folic acid to your diet.

In addition, you’ll be asked to return for another blood test after a specific period of time so your doctor can check that your hemoglobin and hematocrit levels are improving.

To treat vitamin B12 deficiency, your doctor may recommend that you take a vitamin B12 supplement.

The doctor may also recommend that you include more animal foods in your diet, such as:

Your OB may refer you to a hematologist, a doctor who specializes in anemia/ blood issues. These specialist may see you throughout the pregnancy and help your OB manage the anemia.

Preventing Anemia

To prevent anemia during pregnancy, make sure you get enough iron. Eat well-balanced meals and add more foods that are high in iron to your diet.

Aim for at least three servings a day of iron-rich foods, such as:

  • Lean red meat, poultry, and fish
  • Leafy, dark green vegetables (such as spinach, broccoli, and kale)
  • Iron-enriched cereals and grains
  • Beans, lentils, and tofu
  • Nuts and seeds
  • Eggs

Foods that are high in vitamin C can help your body absorb more iron. These include:

Try eating those foods at the same time that you eat iron-rich foods. For example, you could drink a glass of orange juice and eat an iron-fortified cereal for breakfast.

Also, choose foods that are high in folate to help prevent folate deficiency. These include:

  • Leafy green vegetables
  • Citrus fruits and juices
  • Dried beans
  • Breads and cereals fortified with folic acid

Follow your doctor’s instructions for taking a prenatal vitamin that contains a sufficient amount of iron and folic acid.

Vegetarians and vegans should talk with their doctor about whether they should take a vitamin B12 supplement when they’re pregnant and breastfeeding.

The American College of Obstetricians and Gynecologists: “Nutrition During Pregnancy.”

American Society of Hematology: “Anemia & Pregnancy,” “Anemia.”

American Academy of Family Physicians: “Anemia: Causes and Risk Factors.”

National Institutes of Health: “Dietary Supplement Fact Sheet: Iron,” “Dietary Supplement Fact Sheet: Vitamin B12.”

U. S. Department of Health and Human Services Office on Women’s Health: “Anemia Fact Sheet,” “Anemia: Healthy Lifestyle Changes,” “Folic acid fact sheet,” “Pregnancy.”

UCSF Medical Center: “Anemia and Pregnancy.”

National Heart Lung and Blood Institute: “Who Is at Risk for Anemia?”

Cleveland Clinic: “Increasing Iron in Your Diet During Pregnancy,” “Anemia.”

The Merck Manual: “Anemia in Pregnancy,” “Vitamin B12.”

CDC: “Iron and Iron Deficiency,” “Take 400 mcg of Folic Acid Today!”

The Children’s Hospital of Philadelphia: “Anemia in Pregnancy.”

ACOG Practice Bulletin: “Anemia in Pregnancy.”

Academy of Nutrition and Dietetics: “Eating Right During Pregnancy.”

Harvard School of Public Health: “Vitamin B12 Deficiency: Causes and Symptoms.”

University of Maryland Medical Center: “Anemia — Risk Factors.”

American Academy of Family Physicians: “Anemia: Complications.”

Johns Hopkins Medicine: “Anemia of Folate Deficiency.”

Molloy, A. Pediatrics, March 1, 2009.

По материалам:

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Http://www. webmd. com/baby/guide/anemia-in-pregnancy