Anaemia in pregnancy is a common risk factor for expectant mothers. In India, nearly 59% of pregnant women are affected by anaemia. Though it is normal to have mild anaemia during pregnancy, severe anaemia can result in serious complications like preterm delivery and health complications. During the course of anaemia in pregnancy, not only the mother but the baby also gets impacted. Low iron causes the baby to be born with low birth weight. This condition can easily be prevented through medication and a nutrition-based diet; however, being left ignored or unattended can be a nightmare that may lead to the death of the mother or the baby.
The commonest that we observe in our day-to-day practice is iron deficiency anaemia. There are other forms of anaemia such as B-12 deficiency, folate deficiency, and hemoglobinopathy where the mother is unable to increase her red blood cell (RBC) count or haemoglobin levels. Aplastic anaemia is rare during pregnancy wherein there's a total suppression of the bone marrow.
What Can Cause Anaemia in Pregnant Women?
There are many reasons for low iron during pregnancy. Even though all expectant mothers have a risk of iron deficiency; there are certain risk factors for women who are at a greater risk than others.
• Multiple pregnancies (twins, triplets, etc.)
• Heavy menstrual period
• Vegetarian or vegan
• Less consumption of iron
• Incidence of frequent vomiting
• Two pregnancies close together
Symptoms and Treatment
The most experienced symptoms are pallor of the skin, tongue, nails, or eyes. Most women feel tired and complain of giddiness/fatigue, excessive backache, swollen feet, and struggle to breathe (laboured breathing).
Diagnosing Anaemia is quite easy. In hospitals and primary health centres, blood tests (haemoglobin count) are conducted as part of routine check-ups/obstetric practice to identify anaemia. Further treatment takes place depending on the level of anaemia and the duration of pregnancy. Most women are given iron supplements that go on until the time of delivery. In cases where the anaemia is severe or the mother is unable to tolerate oral supplements, an intravenous form of iron supplement is recommended. Some may require blood transfusions as well. In our practice, we have treated a woman in her last trimester with aplastic anaemia. She received several blood transfusions throughout the pregnancy. After the 8th month, when the baby was reasonably matured with no risk of prematurity, we managed to have a successful delivery without any major complications. There were also situations where the expectant mothers had to go through hysterectomies in order to salvage the blood loss during delivery.
How Can Anaemia be Prevented?
Anaemia, though it looks like a simple problem, it is simple only if it is treated in time. Spreading awareness is half the treatment that is completed by taking the right steps toward diets and nutrition. A rich nutrition-based diet that is high in iron can help in improving the overall well-being and iron supplementation of pregnant women. All women should eat green leafy vegetables, broccoli, beetroot, citrus-based fruits, eggs, juices, and organ-based meat intakes like liver, heart, and kidney. A focus should be placed on educating people about the threat of anaemia as well as the importance of taking supplements and eating healthy. All expectant mothers should also be given proper counselling early in their pregnancy in order to have a healthy pregnancy period.
(Dr. Hemanandini Jayaraman, Consultant – Obstetrics & Gynaecology, Manipal Hospital, Old Airport Road, Bengaluru)
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