II. Pathophysiology

  1. Hemoglobin levels change during pregnancy
    1. Wanes in second trimester due to hemodilution
    2. Increases in third trimester
    3. Falls with delivery with placental separation
  2. Anemia in Pregnancy most often nutritional deficiency
    1. Folic Acid Deficiency (Megaloblastic Anemia)
    2. Protein Deficiency (Malnutrition)
    3. Iron Deficiency Anemia

III. Labs

  1. See Hemoglobin Cutoffs for Anemia
  2. See Iron Deficiency Anemia
  3. Hemoglobin Cutoffs
    1. First Trimester: 11 g/dl
    2. Second Trimester: 10.5 g/dl
    3. Third Trimester: 11 g/dl

IV. Management

  1. Hemoglobin 10 to 12 mg/dl
    1. Ferrous Sulfate 325 mg qd for 2 months
  2. Hemoglobin 9 to 10 mg/dl
    1. Ferrous Sulfate 325 mg bid for 2 months
  3. Hemoglobin 7 to 9 mg/dl
    1. Ferrous Sulfate 325 mg tid for 2 months
  4. Hemoglobin <7 g/dl
    1. Consider transfusion
  5. Hemoglobin <6 g/dl
    1. Transfusion to prevent adverse fetal outcome

V. Prevention

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window