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What is fetal anemia during pregnancy. Anemia during pregnancy - what is it? What are the consequences for the child? Risks for mild anemia during gestation

Anemia during pregnancy, or anemia, is a confirmation that at the time of child development, the female body spends a huge amount of red blood cells and iron on the formation of the fetus.

Anemia in this period is mainly a complication of pregnancy in the second and third trimester. Therefore, it is necessary to undergo a diagnostic study of a blood test for iron deficiency and for an index of erythrocytes in the blood.

During pregnancy, 90.0% of all types of anemia are anemia with iron deficiency.

What is hemoglobin and red blood cells

Red blood cells are created in the bone marrow by the action of the kidneys from protein and components that are not bound to protein. Red blood cells provide nutrition and oxygen to the bone marrow, as well as all organs and tissues of the body. They are hollow molecules in their structure, and are filled with a substance - hemoglobin.

Hemoglobin has a red color, which gives a red tint to the erythrocyte. Hemoglobin plays an important role in the transport of red blood cells throughout the human body. The body receives nutrition for every cell. Also through the placenta, nutrients are delivered to the fetus in utero.

Hemoglobin and red blood cells

Kinds

Anemia is classified according to the cause of its occurrence in 3 groups:

Anemia of the posthemorrhagic group- this is a pathology that was provoked by profuse blood loss;
Anemia, which was formed on the basis of pathology in the synthesis of DNA and RNA molecules in the bone marrow;
Group of hemolytic pathology is a disease that develops under the influence of the destruction of red blood cells.

Anemia caused by malnutrition:

Iron deficiency type- low iron in the body, which is important for the synthesis of red blood cells and hemoglobin;
Folate deficiency and anemia with a lack of vitamin B12 - provoked by the lack of protein in the diet.

Pathology provoked by the destruction of erythrocyte molecules:

Anemia hemolytic- caused by a hereditary factor. This is when the process of producing red blood cells is slower than the destruction of red blood cells.

sickle cell Anemia is caused by a malfunction in the production of hemoglobin. Molecules are produced with a defect. Defective molecules cause the erythrocyte molecule to stretch and give the molecule a crescent shape.

The sickle-shaped molecules become inelastic, resulting in a thick biological fluid, the sharp tips of these red blood cells pierce each other, causing death.

Thalassemia- develops due to a low rate of hemoglobin synthesis. Unripe hemoglobin does not have stable characteristic properties and settles in the molecules of erythrocytes in the form of bodies.

An erythrocyte with this pathology has the form of a target molecule.

A disease that is caused by the synthesis of erythrocyte molecules:

Anemia aplastic;
Posthemorrhagic anemia.

The development of anemia, as a complicated form of pathologies of the body:

Anemia associated with liver disease;
The consequence of malignant neoplasms in the internal vital organs;
Diseases in the genital area.

Classification of iron deficiency anemia during pregnancy

The degrees of anemia are divided depending on the hemoglobin index in the biological fluid and on the course of the disease:

Anemia as a contraindication to pregnancy

Not every woman is able to bear a healthy child, and a woman who suffers from anemia has the risk of not only losing the baby, but also putting her life in danger.

Pathologies in which it is dangerous to conceive and bear a baby:

Anemia with iron deficiency, which occurs in a chronic and severe form;
Aplastic anemia (bone marrow stops producing blood in the right amount);
Anemia, which is complicated by leukemia;
Anemia disease associated with Werlhof's disease.

Such severe forms of anemia are very rare, but if the question arises of artificial termination of pregnancy, then this decision is made no later than after the 12th calendar week of intrauterine fetal formation.

Anemia in a pregnant woman is an acquired condition of the body, but during pregnancy it complicates the course of intrauterine development of the baby.

Hemoglobin norms by gestational age

The hemoglobin index in the blood of a pregnant woman should be at least 110.0 - 140.0 g / liter. This level should be at all stages of pregnancy.

If in the 1st trimester - the index reaches 140.0 g / l, then by the 2nd trimester it decreases and reaches 120.0 g / l. The 3rd trimester is the most expensive period for the female body. In this trimester, a woman will spend the most on the development of her baby. a large number of all nutrients. Hemoglobin in the 3rd trimester is from 110.0 - 115.0 g / l.

How does the development process take place?

In fetal development, the baby does not have the opportunity to eat and breathe on its own, therefore, it receives all the substances necessary and useful for development from the mother's body, through the placenta. Oxygen is supplied to the baby by erythrocytes, which are transported by hemoglobin.

The female body has to intensively produce red blood cells in larger quantities, and more hemoglobin is also needed. If an insufficient amount of vitamins enters the body of the expectant mother, then there is a lack of material for the synthesis of red blood cells.

The index of these molecules decreases and the hemoglobin coefficient also decreases.

If the hemoglobin coefficient has decreased to 110.0 g / l, then we can talk about a deviation in the normative indicators of red blood cells during pregnancy.

The reasons

The etiology of anemia in pregnant women is associated with an intense load on the body, as well as changes in hormone levels and a decrease in the protective properties of the body. In the first place is the decrease in the hemoglobin index before the conception of a child and the inability to compensate for it at the time of pregnancy.

Factors that contribute to hemoglobin deficiency:

Avitaminosis;
Not enough food consumed;
Unbalanced diet, starvation;
Failure in the hormonal system;
Use of hormonal contraception;
Diseases in the genital area;
Chronic pathologies of the liver;
Diseases of the heart muscle;
Rheumatism;
Problems in the performance of the kidneys;
Disease of the pancreas;
Diabetes;
Nosebleeds that have a chronic stage;
Large volume of menstrual blood output;
Early age for pregnancy;
Late pregnancy (after 30 calendar years);
woman smoking;
The systematic use of alcoholic beverages;
Polyhydramnios in a pregnant woman;
Carrying 2 or more children at the same time;
Hereditary genetic predisposition;
Short term (less than 4 calendar years) between pregnancies.

Products containing iron

There may be external provocateurs, this is intoxication of the body, which is associated with work activity, and is systematic.

In the pathology of the body, the entire supply of iron accumulates in the area of the focus of the disease, and the rest of the organs feel its deficiency.

Over the entire duration of pregnancy, a woman loses 900.0 milligrams of iron. In order to fully restore it in the body, you need a long time.

Signs of anemia during pregnancy

Signs of anemia during pregnancy are anemic, which are associated with the general condition of the body and sideropenic, associated with iron deficiency.

Anemic symptoms are manifested as follows:

The skin is dry to the touch and there is a process of exfoliation of the epidermis;
A state of weakness in the body;
Constant desire to sleep;
Spinning of the head, sometimes severe and causing a state of fainting;
Low blood pressure index (hypotension);
Shortness of breath on exertion and when relaxed;
Muscle tone is weak.

Sideropenic signs are:

Also, with severe anemia, symptoms of cardiovascular disease appear.

Why is anemia dangerous during pregnancy?

Anemia in a pregnant woman can lead to serious consequences, dangerous complications in the birth process and pathologies of fetal formation.

Complicated anemia during pregnancy:

Experts believe that the cause of frequent colds in young children is the consequences of complicated anemia during pregnancy. Also, anemia in the expectant mother provokes allergies in the baby in 30.0% of cases of allergies in children.

Consequences for the child

Anemia in a pregnant woman can cause complications during the period of intrauterine fetal formation and provoke pathologies in a born baby:

Low birth weight;
Retardation in physical formation;
The baby's umbilical cord heals slowly;
The occurrence of anemia after childbirth;
Belated development of motor skills of the child;
Deviations in mental development;
Low immunity.

Gestational form

Gestational anemia affects up to half of pregnant women. The gestation period (the entire period of pregnancy) occurs when a fertilized egg enters the uterus.

This form of anemia is associated only with the process of pregnancy. If a woman has developed anemia before the time of gestation, then she does not apply to this form.

With this form of anemia, there is a violation in the fixation of the fetus in the placenta. It is caused by hypoxia of the placenta. The development of the fetus during the 1st trimester begins in the upper layer of the uterus. 2 semester there are changes in the formation of the fetus.

The small capillaries of a pregnant woman burst from the load, and the child suffers even more from hypoxia.

Anemia due to iron deficiency

In the human body, the content index of iron molecules should be at least 4 grams. And if you calculate the individual index, then it should be 0.0000650% of the total body weight of a person. 58% of all iron in the body is iron, which is found in hemoglobin.

The stock of this substance is deposited in the cells of the liver, in the cells of the spleen and stored in the bone marrow. The loss of iron by the body occurs constantly - this is at the time of urination (with urine), with feces, with sweating.

Iron deficiency anemia during pregnancy provokes most of the complications. Increased consumption of hemoglobin by the body, increases iron deficiency. To constantly replenish iron, you need to replenish proper diet and, prescribed by doctors, medicines.

With reduced hemoglobin, which is caused by iron deficiency in a child, oxygen starvation may occur, since nutrients and oxygen will be transported uninterruptedly.

Hypoxia is the first provocateur of abortion and premature birth.

Causes of iron deficiency during pregnancy:

Increased need of the body, with little compensation;
Pathology in the intestines, in which iron is not fully absorbed.

Diagnostics

Identification of iron deficiency anemia is carried out by laboratory study blood composition.

Confirmation of the diagnosis of iron deficiency anemia in a pregnant woman is when the following indicators are in the test results:

The presence of hemoglobin indicators is practically absent;
Hemoglobin index reduced to 60.0 - 70.0 grams per liter of blood;
Erythrocytes are low - 1.5 - 2.0 t / l;
Erythrocytes of various atypical forms appeared in the blood composition.

Erythrocytes: a - normal (discocytes); b - target-like (platycytes); c - stellate (acanthocytes); d - sickle-shaped (drepanocytes); e - semilunar (meniscocytes); f - dangling (schistocytes); g – mouth shapes (stomatocytes); h - oval (elliptocytes); and - spherical (spherocytes).

Anemia folate deficiency and B12 deficiency

With a small amount of B12 and folic acid in the body, deviations from the normative indicators occur in the synthesis of bone marrow cells.

This type of anemia is on the same position in the group of pathologies of anemia, along with anemia, which is caused by iron deficiency in the body. This group of diseases is caused by diseases that are in the chronic stage.

Deficiency of this substance causes proper nutrition and the absence in his diet of a sufficient amount of animal products: meat products, especially red meats, liver and liver, dairy products and eggs.

Replenishment in the body of B12 and folic acid molecules must go constantly, since this vitamin is lost during the daily physiological processes of the release of the intestines and bladder.

Causes of vitamin B12 and folic acid deficiency:

Detection through diagnostics

According to the results general analysis blood composition, the following indicators are noted:

The quantitative index of erythrocytes is lowered;
Large erythrocytes;
Color level not less than 1.1;
The hemoglobin index is low;
Poor quality of erythrocytes - there are remains of the nucleus in the molecules;
Low reticulocyte count;
Low neutrophil count;
Decreased platelet count;
Deviation from the norm towards a strong increase in all cells.

Diagnostics

Diagnostic study begins with a general examination of the pregnant woman. It is also necessary during pregnancy to take regular urine and blood tests.

According to a blood test, it is determined:

hemoglobin index;
The number of red blood cells;
Leukocytes;
Hemocrit in the blood.

If, according to the result of the blood test, deviations from the norm are revealed, then the attending doctor directs for additional studies:

Ultrasound examination of the kidneys;
Ultrasound of the stomach and intestines.

If all coefficients indicate anemia, a biochemical analysis is performed to study the causes:

Serum iron concentration;
The degree of ability to bind iron molecules to serum fluid, for transferrin (protein transport).

How to treat anemia during pregnancy

Therapy of anemia during pregnancy takes place in accordance with the form of anemia and the stage of development of the pathology.

1 degree of anemia in pregnant women is treated with a diet.

The second and third degree of anemia is treated with iron-containing preparations, and also, if necessary, with folic acid and B12 preparations. The diet at the second and third stages will not be able to make up for the necessary deficiency of substances.

All medicines are prescribed by a doctor who controls anemia during pregnancy, and also adjusts the treatment regimen. In addition to drugs for anemia, you need to take medicines to treat comorbidities.

Medicines for anemia:

Ferroplex;
Ferrocal;
Tardiferon with folic acid;

Medical therapeutic course - up to 6 calendar months. After childbirth, if there is a question that anemia is present in the body, then therapy must be continued.

Diet for anemia

In order to make up for the deficiency of anemia in the first stage of pregnancy, it is necessary to follow a diet with a high content of iron in foods.

Recommended Foods	Not Recommended Foods
meat - veal, chicken, beef liver, tongue;	Meat - lamb, fatty beef, pork;
fatty fish - mackerel, sturgeon family;	· animal fat;
porridge - buckwheat, millet, barley;	Foods containing trans fats.
· fresh vegetables- tomatoes, red beets, cabbage of all kinds, carrots;
garden greens - spinach, parsley, dill;
berries - gooseberries, black and red currants, raspberries, strawberries;
· fresh fruits- green apples, plums, peaches, persimmons;
natural honey.

Preventive actions

A woman, even 3 calendar months before the conception of a child, needs to undergo a diagnostic blood test for an index in its composition of hemoglobin and for the detection of anemia. The same period of time is necessary to take vitamins B9, B12 and iron.

To prevent the pathology of anemia, you need to take a complex of vitamins for the period of pregnancy, which contains no less than 60.0 milligrams of iron, as well as 250.0 μg of vitamin B9 (folic acid).

This complex is intended only for preventive measures of deficiency of essential substances. In case of detection of anemia, you need to take drugs to make up for the lack of these vitamins in the body.

The scheme of the therapeutic course is prescribed by the attending doctor. Self-medication during pregnancy is fraught with abortion or the birth of a defective child.

Importance of vitamins during pregnancy

Preventive measures for anemia in expectant mothers should begin with childhood girls.

The function of vitamins for the female body is very important:

Vitamin C- it is an antioxidant that strengthens the protective functions of the body and helps the absorption of iron;
Vitamin E- it is a protector of the placenta during pregnancy from the effects of external factors;
Vitamin B 9(folic acid) - necessary for the prevention of anemia;
Vitamin B 6- important for the synthesis of hemoglobin in the blood;
Vitamin B 12- necessary for the synthesis of red blood cells.

In order to compensate for the lack of vitamins during pregnancy, it is necessary to take special vitamin complexes for pregnant women. These complexes are selected taking into account the consumption of vitamins for the formation of an unborn child.

During the physiological course of pregnancy, the volume of blood gradually increases. Although the mass of red blood cells in the blood increases, the volume of the liquid component, or plasma, increases to a greater extent. This leads to a relative dilution of the contents of the bloodstream.

Gestational anemia, or hydremia, is characterized by physiologically reduced levels of hemoglobin and hematocrit, but the mean volume of red blood cells (MCV) and their shape do not change. This indicator (MCV) is determined by the automatic interpretation of the results of a blood test.

In some pregnant women, pathological anemia occurs, which in 75-95% of cases is associated with a lack of iron.

Physiological causes

In any pregnant woman, plasma volume increases to a greater extent than red blood cell mass. As a result, blood thinning, or hemodilution, occurs. This condition is not morbid anemia in the true sense of the term.

Hemodilution has a physiological meaning:

more liquid blood penetrates better through the placental vessels and nourishes the embryo;
during childbirth, the absolute number of lost erythrocytes decreases.

Therefore, a decrease in hemoglobin concentration to 100-110 g / l in pregnant women is normal in many cases. With such figures, iron preparations are sometimes not prescribed, it is enough to follow the right diet. This condition is not accompanied by pathological symptoms. 1-2 weeks after birth, blood counts return to normal.

Pathological causes

Anemia in pregnancy can be caused by a variety of reasons. Depending on the MCV value, it is classified into three groups:

MCV less than 80 fL - microcytic, the volume of erythrocytes is reduced.
MCV 80 - 100 fL - normocytic, the average volume of erythrocytes is normal.
MCV more than 100 fL - macrocytic, red blood cells are larger than normal, but poor in hemoglobin.

Causes of anemia with low MCV:

iron deficiency;
thalassemia;
chronic diseases of a pregnant woman;
sideroblastic anemia;
copper deficiency;
lead poisoning, for example, in hazardous industries.

The normocytic form in pregnant women can be caused by such reasons:

blood loss;
physiological anemia;
slight iron deficiency;
chronic diseases;
oppression of hematopoiesis in the bone marrow;
chronic renal failure;
autoimmune hemolytic form;
hypothyroidism (dysfunction of the thyroid gland) or hypopituitarism (dysfunction of the hypothalamus).

Macrocytic variant of the pathology occurs in such cases:

folate deficiency anemia;
B12 deficient;
pathology caused by medication;
reticulocytosis;
liver disease and alcoholism;
acute myelodysplastic syndrome.

Factors contributing to the development of anemia:

consecutive pregnancies;
adolescence of a pregnant woman;
low iron content in foods;
anemia that existed before the onset of gestation;
intense vomiting due to;
transferred pyelonephritis, hepatitis A;
chronic diseases - gastritis, tonsillitis, pyelonephritis, rheumatic heart defects, diabetes;
heavy menstrual or uterine bleeding observed before pregnancy;
hemoglobin in the 1st trimester is less than 120 g/l;
the onset of pregnancy during breastfeeding of a previous child;
vegetarianism;
or the threat of interruption of gestation.

Prevalence

A decrease in hemoglobin concentration to 100 g/l or less, associated with iron deficiency, is diagnosed in 20-80% of pregnant women. The level of this trace element in the serum is reduced in 50-100% of women. In Russia, the frequency of the iron deficiency form of pathology in pregnant women is from 30 to 40%. This is an average figure, in European countries the incidence of such a disease is lower.

Another fifth of pregnant women have hidden iron deficiency, which persists even after the birth of a child.

Why anemia develops:

the need for this trace element by the 3rd trimester reaches 12-18 mg / day;
about 400 mg circulates in the fetal circulation;
500 mg of this substance is used to increase the volume of a woman's blood;
during childbirth, up to 170 mg of iron is lost, and during lactation - another 420 mg of iron.

Therefore, by the end of breastfeeding, iron deficiency can reach 1400 mg.

The most common forms of pathology

In pregnant women, a decrease in hemoglobin content is most often recorded, caused by a deficiency of iron, folic acid, or vitamin B12. This condition occurs much more often in the 2nd or 3rd trimester of gestational age.

Iron-deficiency anemia

This form occurs when there is a lack of iron required for the formation of hemoglobin. It is a protein found in red blood cells that carries oxygen to tissues. With this form of pathology, a lack of oxygen develops in the cells of the woman and the fetus. This is the most common cause of anemia in pregnant women.

Folic deficiency form

Folic acid is found in leafy greens and some other foods. It is necessary for the formation of new cells, including red blood cells. During pregnancy, a woman needs more folic acid. However, it is often not enough in the diet. This can lead to pathologies in the baby, such as neural tube abnormalities (back bifida) or low birth weight. Therefore, folic acid supplements are essential for every pregnant woman.

B12-deficient form

With insufficient intake of vitamin B12 into the body of a pregnant woman, her bone marrow cannot synthesize normally functioning red blood cells. The greatest risk of developing this variant is in women who follow a vegetarian diet, do not eat meat, poultry, milk, eggs. Vitamin B12 deficiency can cause abnormalities in the formation of the nervous system of the fetus and premature birth.

Severity

Depending on the level of hemoglobin (Hb), the following degrees of anemia are distinguished:

Lower limits of the norm:

hemoglobin - 100 - 110 g / l;
hematocrit 0.32;
erythrocytes 3.5 x 1012/l.

The WHO classification includes the following gradation of the severity of pathology:

mild degree - Hb 90-110 g / l;
2 degrees (moderately pronounced) - 70-89 g / l;
severe - below 70 g / l.

signs

Symptoms of anemia during pregnancy:

pale skin, lips, nails, mucous membranes;
constant fatigue;
dizziness;
dyspnea;
frequent heartbeat;
difficulties in mental and physical work;
sometimes unusual taste preferences - the desire to eat chalk, plaster, clay or other inedible substances;
Difficulty swallowing with sensation of "lump in throat".

Anemia of the 1st degree may practically not manifest itself outwardly. Often, its signs resemble the usual weakness for pregnancy, deterioration of well-being. However, this condition can harm the woman and the child. Therefore, all pregnant women should take blood tests as prescribed by the doctor.

As it appears on external examination:

pallor of the skin and mucous membranes;
dryness and cracked skin;
"zaedy", cracks in the corners of the lips;
there may be a slight yellowness of the area above the upper lip, the skin of the hands, caused by a violation of the metabolism of vitamin A with a lack of iron;
muscle weakness;
fragility and striation of nails;
hair loss, brittle ends;
burning sensation in the vulva.

Signs of anemia during pregnancy, both clinical and only laboratory, should be the reason for starting treatment.

Possible consequences

In severe iron deficiency, the effects of anemia on the child include:

prematurity or low birth weight;
low hemoglobin content in a child;
lagging behind the baby in mental and physical development.

With an iron deficiency form of the disease, the risk of such complications increases significantly:

OPG-preeclampsia;
premature birth;
untimely outpouring of waters;
weakness of labor activity;
increased blood loss during childbirth;
postpartum septic (infectious) complications;
- Lack of breast milk.

What is dangerous during pregnancy anemia caused by a lack of folic acid:

prematurity, low birth weight;
the formation of a severe congenital defect of the spine, spinal cord or brain.

Untreated vitamin B12 deficiency can also lead to neural tube defects in the fetus.

Diagnostics

At the first appointment with a gynecologist, a woman is given a referral for a general blood test, and in the future it is repeated. This simple study makes it possible to diagnose anemia of any severity and suggest its cause. The blood test determines the level of hemoglobin, red blood cells, hematocrit.

If iron deficiency is suspected, the determination of total serum iron-binding capacity (TIBC), saturation of transferrin with iron and serum iron can be additionally assigned.

Criteria for suspecting iron deficiency anemia:

hemoglobin less than 100 g/l;
decrease in color index to 0.85 or less (hypochromia);
microcytosis, anisocytosis - a decrease in the size and change in the shape of red blood cells;
decrease in the diameter of erythrocytes less than 6.5 microns;
OZHSS more than 64.4 µmol/l;
Serum Fe up to 12.6 µmol/l;
saturation of transferrin with iron up to 16%;
the most informative indicator is serum ferritin up to 12 µg/l.

To detect a lack of folic acid, its content in serum and in erythrocytes is determined. A lack of vitamin B12 is confirmed by a blood and urine test for the concentration of cyanocobalamin.

Treatment

Mild anemia is treated by prescribing iron supplements and. A woman is recommended complex vitamins for pregnant women, including required amount all trace elements. It must be understood that with this disease, diet alone will not be enough.

In the macrocytic form of the disease caused by vitamin B12 deficiency, it may be necessary to administer this substance in the form of injections. Treatment of anemia in pregnant women in this case necessarily includes good nutrition with the inclusion of meat, eggs, dairy products.

Drugs prescribed for anemia in pregnant women

During pregnancy, drugs are prescribed only by a doctor, therapy should begin when the hemoglobin level drops to 110 g / l. It is better to use tablets containing, in addition to iron, ascorbic acid, for example, Sorbifer Durules. Against the background of taking medications, a blood test is repeated every 10 days, therapy continues until the end of pregnancy, regardless of the improvement in blood counts.

Clinical recommendations based on WHO data include the use of Fe preparations in all pregnant women in the 2nd and 3rd trimesters and in the first six months of breastfeeding, even in the absence of signs of low hemoglobin. However, in each case, the decision on the appointment of these funds is made individually.

Anemia of the 3rd degree requires hospitalization in a hospital. With such low levels of hemoglobin, a woman is prescribed a red blood cell transfusion. However, this procedure carries the risk of infection. infectious diseases. Therefore, it is better to detect and begin treatment of pathology at an early stage in time.

Of the Fe preparations, preference should be given to:

tableted rather than injectable forms;
products with ferrous iron in the composition;
ferrous sulfate derivative.

Effective medicines:

drops, syrup or capsules Aktiferrin;
Biofer (chewable folic acid tablets);
Gino-tardiferon (prolonged tablets with folic and ascorbic acid);
Totem (solution for oral use with copper and manganese);
Fenyuls (iron sulfate and ascorbic acid);
Feroglobin B12 (combination of Fe and multivitamins).

Medicines in the form of injections are prescribed to pregnant women only in special cases:

severe diseases of the small intestine (enteritis, consequences of operations on the intestine);
nausea or vomiting that occurs with the use of any iron preparations inside, regardless of the form (drops, syrups, and so on);
the need to quickly restore the level of Fe in the body, for example, if a pregnant woman needs surgery;
additional use of erythropoietin, which without a sufficient supply of this trace element in the body will be ineffective.

Such restrictions are associated with the fact that with an increased intake of Fe into the blood and a lack of transferrin carrying it, severe allergic reactions are possible. Trivalent preparations are used in combination with plasma-substituting solutions. Calculation of the course dose for injection: body weight (kg) x hemoglobin level (1 g / 100 ml) x 2.5.

After a course of injections, medications are prescribed in tablets. The doctor should determine the duration and dosage of iron intake. An excess of this trace element can be deposited in the liver, lungs and other organs, disrupting their function. On the other hand, a maximum of 300 mg of iron can be absorbed per day, so exceeding this indicator is impractical.

Side effects of iron supplements

In some patients, taking iron-containing preparations causes quite pronounced side effects - nausea and vomiting, abdominal pain, constipation or diarrhea. Their probability increases with increasing dosage of the drug. Sometimes they become the reason for the cancellation of tablet forms and the need for injection.

When using tablets, the stool turns black.

Rarer side effects include:

the formation of an ulcer of the esophagus;
skin rash and itching;
dizziness and headache;
weakness, fever.

Prevention

Prevention of anemia in pregnant women is required at a high risk of developing this pathology:

a previous decrease in hemoglobin;
chronic infections or internal diseases;
repeated childbirth;
hemoglobin in the 1st trimester less than 120 g/l;
multiple pregnancy;
before pregnancy, the duration of menstruation is more than 5 days.

For prevention, a diet and iron-containing medicines are prescribed. Medicines should be taken at a low dosage, starting from the 12th week, for six months.

The heme form is part of hemoglobin. It is found in animal products that initially include this protein. These are red meat, fish and poultry. This form is quite well absorbed in the intestines.

Non-heme iron is found in plant foods, its absorption is much worse. Therefore, of course, vegetables and fruits should be part of the menu of a pregnant woman, but you do not need to rely on them as a means of preventing and treating anemia. This, in particular, applies to such popular products as apples and pomegranates.

beef, pork, chicken liver;
sardines canned in oil;
halibut, sea bass, salmon;
veal, beef;
lean natural ham.

lentils, beans, spinach;
tofu cheese;
pumpkin, sesame, sunflower seeds;
pistachios, peanuts, cashews, walnuts, toasted almonds;
apricots, raisins, peaches, prunes;
baked potato;
egg noodles;
germinated grains of wheat;
boiled peas;
brown rice;
whole grain or bran bread.

Some foods promote the absorption of iron from food, while others prevent it.

To improve the absorption of the trace element, it is recommended to give up strong coffee and tea, and use more foods rich in calcium, such as milk.

To improve absorption, sources of vitamin C should be added to the menu - broccoli, rosehip broth.

Indicative daily menu:

The list of products useful for anemia includes citrus fruits, strawberries, oysters and shrimp, eggs, but they are not recommended for pregnant women because of their high allergenicity, as well as chocolate, mushrooms and raspberries.

Due to the significant risk of developing anemia, doctors recommend approaching pregnancy planning very responsibly. If necessary, the expectant mother undergoes additional treatment to increase the level of hemoglobin.

During the bearing of a child, measures must be taken to prevent anemia. Particular attention should be paid to diet. It must include meat dishes. It is from here that a person receives iron. For the sake of the health of the unborn child, vegetarians are advised to at least temporarily review their diet.

To prevent blood pathology, iron-containing medicines are used as prescribed by a doctor. It is usually advised to take them daily for six months, starting from 14-16 weeks of pregnancy. Daily dose iron should be about 60 mg, and folic acid - 250 mg.

The article discusses anemia during pregnancy. We talk about its degrees, symptoms and consequences for the child. You will find out why anemia is dangerous in pregnant women, what treatment is prescribed, the necessary prevention and feedback from women.

Anemia (anemia) is a condition characterized by a decrease in the number of red blood cells and a decrease in hemoglobin content per unit volume of blood. The term "anemia" without specification does not define a specific disease due to the fact that anemia is one of the signs of various pathological conditions of the human body.

Anemia in pregnancy

Experts highlight:

hydremia (hemodilution) - pseudoanemia, for example, in expectant mothers, and anemia;
anemia - with hydremia, the level of blood cells (platelets, leukocytes, erythrocytes) and hemoglobin remain unchanged, but the volume of the liquid part of the blood increases.

Anemia is not a disease, but just a sign that accompanies a number of diseases and pathologies that may be due to a primary lesion of the blood system or not depend on it. For the classification of anemia, it is customary to use the principle of practical expediency.

The classification of established clinical practice is as follows:

anemia, which is associated with acute blood loss;
anemia that has arisen against the background of a violation of the production of erythrocytes: iron deficiency, megaloblastic, aplastic, sideroblastic, chronic pathologies;
anemia due to increased destruction of red blood cells: hemolytic.

The modern classification of anemia is based on clinical and laboratory symptoms that allow differential diagnosis of anemia.

Most often, anemia during pregnancy (ICD code 10 - O99) has an iron deficiency form, which is characterized by a decrease in the number of red blood cells that are responsible for delivering oxygen to organs and tissues and a decrease in the level of red blood cells.

Degrees

Specialists distinguish such degrees of anemia:

Mild degree - with this form, there are practically no signs that indicate changes in the body. Hemoglobin indicators are 110-90 g / l.
Average degree - hemoglobin values are 89-70 g / l
Severe - hemoglobin levels are 69-40 g / l.

What is dangerous anemia during pregnancy

During the period of bearing a child in the body of a woman, the level of fluid rises, which leads to an increase in the volume of circulating blood. As a result, the blood “thinns” and the level of hemoglobin in its total volume decreases. This phenomenon is considered normal, in connection with this, the lower limit of the amount of hemoglobin in pregnant women is set at 110 g / l (for non-pregnant women, the norm is 120-140 g / l).

The main problem that occurs when there is a lack of hemoglobin is tissue hypoxia (in which there is an insufficient supply of oxygen to the cells of the body). Other consequences for the fetus is hypoxia, which disrupts the development of the child. In addition, the composition of the placenta changes, which negatively affects both the course of pregnancy itself and the condition of the baby in the womb.

The most common complications associated with anemia during pregnancy are:

risk of abortion;
childbirth before the due date;
delayed fetal development;
premature detachment of the placenta;
anemia in the first year of a child's life.

It should be understood that anemia during pregnancy is a rather dangerous condition for the pregnant woman and the fetus. On average, 15-30% of all pregnant women suffer from anemia.

The reasons

The main factors affecting the development of anemia in pregnant women are:

iron consumption for maternal and fetal hematopoiesis. The active consumption of iron increases at 16-20 weeks, due to the start of hematopoiesis in the fetus. By the end of pregnancy, every woman's iron stores run out, and it will take 2-3 years to fully replenish them;
lack of iron in food, especially in those who do not eat meat;
lack of B and C vitamins, which are important for the normal absorption of iron;
early toxicosis, which interferes with good nutrition;
frequent childbirth, between which there is a small interval;
diseases against which there is a lack of proteins involved in iron metabolism, including severe preeclampsia.

The following women are at risk:

multiple pregnancy;
multiparous;
prolonged menstruation (more than 5 days) before conception;
having preeclampsia;
those who have had signs of anemia in past pregnancies;
chronic diseases of the gastrointestinal tract, liver;
the presence of chronic infections;
those who do not eat meat (vegetarians).

Women at risk should adhere to certain prevention during pregnancy and follow all the instructions of their doctor.

Poor health in a pregnant woman

signs

Symptoms of anemia in pregnant women appear due to:

lack of hemoglobin in the blood, which leads to a violation of the “cellular respiration” of tissues;
lack of iron in tissues and failure of metabolic processes associated with it.

The main signs of anemia that has arisen against the background of hypoxia include:

loss of strength, rapid fatigue;
, in the daytime, a woman constantly wants to sleep, and at night she suffers from insomnia;
frequent;
dyspnea;
loss of consciousness;
cardiopalmus;
noise in ears;
bouts of dizziness.

Symptoms of anemia that occur due to a lack of iron in the tissues:

fragility and delamination of the nail plate;
dryness, seizures, cracks and inflammation of the border of the lips;
hair loss, dryness and brittleness;
dry and cracked skin.

In early pregnancy, namely in the 1st trimester, a mild degree of anemia may not have characteristic symptoms due to the fact that the body can still compensate for the lack of oxygen. Over time, a woman can observe changes in the structure of the nail plate and hair, dry skin. But most often these signs are ignored, as future mothers believe that they are just one of the conditions characteristic of pregnancy.

Each person suffers anemia individually. Someone loses consciousness at high levels of hemoglobin, and someone refuses to be hospitalized even when the hemoglobin level drops below 80 g / l, believing that such a condition will not lead to dangerous consequences. It should be understood that in this case there is a need to provide medical assistance, otherwise the pregnancy will be terminated or the child will be born with serious illnesses.

That is why it is important to regularly visit a doctor and undergo all the necessary examinations. What tests should be taken to detect the presence of anemia? It is enough to pass a general blood test, at least 2 times a month. Pay attention to the value and the fall in the amount of iron in the blood serum (less than 12 µmol / l) and serum ferritin. A drop in the level of the latter to 12 μg / l indicates an iron deficiency, even when the amount of hemoglobin is normal.

Treatment

Treatment of anemia during pregnancy should be comprehensive. Therapy includes taking certain medications and following a special diet. Below are the details.

Preparations

WHO experts believe that from the 2nd trimester, the daily intake of iron in each pregnant woman should be at least 60 mg, and when the first signs of anemia appear, this figure should be doubled. Getting such an amount of iron from food is quite problematic, especially when anemia has already manifested itself.

That is why expectant mothers are prescribed iron supplements. As a rule, they are taken orally and only in severe cases and in stationary conditions can injections of iron preparations be used.

Tablets:

Sorbifer Durules;
Ferlatum;
Maltofer Fall;
Ferrum Lek;
totem;
Hemopher.

The expectant mother can take dietary supplements and multivitamin complexes with iron from anemia for preventive purposes. But in this case, the composition of the preparations should be:

iron salts - optimally ferrous sulfate or gluconate;
vitamins - WHO experts advise taking iron supplements along with vitamin C and.

The effect of taking such funds will be noticeable only after 6 weeks.

You should refrain from taking drugs and dietary supplements with iron in such cases:

individual intolerance;
an excess of iron in the body (hemosiderosis, hemochromatosis);
some blood diseases, such as leukemia or lymphogranulomatosis.

Proper nutrition during pregnancy

Food

One of the main components of the treatment and prevention of anemia in pregnant women is proper nutrition.

During diet therapy, it is important to consume foods that contain a sufficient amount of substances important for normal hematopoiesis. You can get iron from foods such as meat, vegetables, and fruits. You should pay attention to:

pork liver;
chicken and beef liver;
beef and pork heart;
lamb, beef, pork, chicken, turkey meat;
seafood;
sea fish;
wheat bran;
buckwheat grain;
spinach;
corn;
dried apricots;
apples;
pomegranate;
dried fruits;
greens;
legumes;
eggs.

Iron, which is contained in meat, is absorbed by 40-50%, while from plant products - only by 3-5%. Therefore, experts recommend getting iron from meat products, especially during pregnancy.

Prevention

To avoid anemia during the period of bearing a child, it is enough to follow these simple rules:

Regularly visit a gynecologist and take all the necessary tests in a timely manner.
Include iron-rich foods in your daily diet.
At the first suspicion of the development of anemia, immediately seek medical help.

Many women are concerned about anemia during pregnancy. That such a phenomenon often occurs in expectant mothers is not a secret, but there is a logical explanation for this. The female body during pregnancy makes the most of all the resources, reserves of vitamins and minerals to maintain and develop a new life.

Hemoglobin is lowered. What does it mean, the norm of hemoglobin, signs of low hemoglobin during pregnancy

When registering with a antenatal clinic, a gynecologist prescribes a blood test for a pregnant woman. One of important indicators it has a hemoglobin level.

Hemoglobin is a protein in the blood that is responsible for transporting oxygen through red blood cells - erythrocytes. The concentration of these substances determines the hemoglobin index of the blood, which is necessary for normal life. Anemia is a blood disease that is characterized by a decrease in the number of red blood cells and hemoglobin.

A hemoglobin value below 110 g/l is considered abnormal. During pregnancy, anemia (anemia) is a complication and poses a threat to the health of the mother and fetus. Not enough oxygen is supplied to the organs for their normal functioning.

The first signs of the disease: pallor skin, dry and damaged hair, nails begin to exfoliate and break. With a drop in hemoglobin, other symptoms are added to these manifestations, more characteristic of iron deficiency anemia.

Iron deficiency anemia (IDA) during pregnancy. What is it, causes, how it manifests itself

The most common form of anemia during pregnancy is iron deficiency anemia (IDA). It is believed that such a disease develops due to the increased use of iron by the fetus and insufficient compensation for the deficiency that occurs in the body of a pregnant woman due to her nutrition.

Anemia during pregnancy can also develop due to a meager menu, lack of vitamins and protein in the diet of the expectant mother. The presence of iron in the blood is responsible for delivering oxygen to the fetus. In women in an interesting position, the volume of circulating blood increases, this happens in order to ensure normal breathing of the crumbs in the mother's womb.

The body forms a new placental circle of blood circulation, which ensures the supply of nutrients to the embryo. Erythrocytes do not keep up with the increasing volume, and this affects the level of hemoglobin. The increase in volume is also caused by the fact that the body has its own reserve in case of large blood loss during childbirth.

The supply of iron and own red blood cells from the body of a pregnant woman are generously spent to meet the respiratory needs of the fetus. The chemical element iron plays a major role in the synthesis of hemoglobin: it binds oxygen and transports it to all tissues and organs.

Anemia can be diagnosed at the beginning of pregnancy by external manifestations: pallor of the skin. In 40% of women, iron deficiency anemia is diagnosed only in the second trimester. At this time, the oxygen consumption for the life support of the fetus increases, so there are clear signs of anemia in pregnant women.

For clinical symptoms that occur in the second trimester, are characterized by:

general soreness, frequent fatigue, drowsiness;
mood swings;
cracks, jams in the corners of the lips, dryness and peeling of the skin of the feet and palms;
fragility of hair and nails.

In the most severe stages of the disease, the following clinical signs are accompanied:

an increase in the number of heartbeats, sometimes accompanied by chest discomfort;
nausea, vomiting, loss of appetite;
dizziness, fainting;
decreased concentration, distracted attention;
feeling of numbness of the limbs.

How does anemia affect pregnancy? What is the danger of low hemoglobin in the early, late periods

Anemia negatively affects both the health of the pregnant woman and the health of the fetus at any stage of pregnancy. Reduced hemoglobin leads to general weakness, fatigue. The lack of oxygen in the body of a pregnant woman also leads to palpitations, shortness of breath during physical exertion.

With a significant decrease in hemoglobin, fainting may occur., frequent dizziness and headaches. Fainting is definitely dangerous during pregnancy. A short-term loss of consciousness can happen at any time, a sudden fall is fraught with various injuries.

With severe anemia, a violation of the placental circulation begins, because of this, the unborn child feels a lack of oxygen and nutrients. In the third trimester, anemia can cause late toxicosis, which often leads to premature birth.

Degrees of anemia during pregnancy: symptoms, how it manifests itself, how dangerous it is

There are three stages of the disease:

Easy degree.
Average degree.
Severe degree.

At the first stage, iron deficiency can be compensated by a special diet. The second stage requires drug treatment. And the most difficult third stage requires hospitalization. Anemia can develop independently and against the background of concomitant diseases.

Provoking the development of anemia are the following reasons:

poor diet and lack of nutrition;
taking contraceptives before pregnancy (especially without medical supervision), hormonal failure;
internal pathologies, especially chronic diseases of the liver and intestines;
age characteristics of the organism (up to 15 years and after 30);
heavy menstruation in history;
bad habits.

Multiple pregnancy is a common cause of iron deficiency. Pregnancy is in itself a heavy burden on the female body, and twins or triplets are a burden multiplied by the number of babies. Multiple pregnancy is almost always accompanied by anemia, since it is difficult to compensate for the cost of iron with nutrition alone.

IDA poses a threat to mother and baby. Anemia causes toxicosis in the later stages, can provoke premature birth. Iron deficiency affects blood clotting, which can lead to bleeding during childbirth (posthemorrhagic anemia). Later, anemia can be complicated by loss of lactation.

Low hemoglobin levels adversely affect the growth and development of the fetus. He receives less than necessary for the formation of all systems and oxygen breathing. Lack of nutrients, due to these processes, creates a risk of birth with a lack of weight, and becomes the cause of fetal hypoxia.

The immunity of a child with inadequate intrauterine nutrition cannot be formed at the proper level. Children whose mothers experienced iron deficiency during pregnancy are often born small and weak, easily susceptible to disease.

Anemia 1 (mild) degree (severity, stages)

Many pregnant women in the antenatal clinic are given a mild degree of anemia. This stage is considered the easiest and most common. Such anemia is characterized by a decrease in hemoglobin levels within 110 - 90 g / l. Based on a blood test or a serum iron test, a gynecologist diagnoses iron deficiency anemia.

It is important that a disease such as anemia during pregnancy in a mild degree, in most cases, can be overcome by adjusting the diet and iron supplements.

With the onset of the birth of a new life, the female body begins to rebuild, and under new conditions does not have time to provide the increasing volume of circulating blood with a sufficient number of red blood cells (erythrocytes). Almost every woman faces mild IDA during her life.

The clinically mild stage may not manifest itself in any way. Sometimes there is a characteristic pallor of the skin. Many women mistakenly attribute the first signs of the disease to early toxicosis. Only a doctor can make a diagnosis, and he will also give recommendations or prescribe treatment.

Even the initial degree of anemia is not entirely harmless. Indeed, even with a slight decrease in the level of iron, the fetus experiences a slight hypoxia. Ignoring the fact of IDA is dangerous even to a mild degree. This can lead to a further drop in hemoglobin, which will lead to underdevelopment of the fetus and its oxygen starvation.

Anemia 2 (medium) degree (severity, stages)

The second (medium or moderate) degree of IDA has a more noticeable effect on health and well-being, a pregnant woman constantly feels general weakness and malaise. The level of hemoglobin in the blood is within 70 - 90 g / l.

At this stage, the signs of the disease cannot be missed and ignored. There is hair loss above the physiological norm, brittle nails, cracks (jamming) in the corners of the lips. Expectant mothers may experience frequent ailments, dizziness, headaches, complain of poor appetite and insomnia. Sometimes there may be irritability and mood swings.

Of course, average anemia during pregnancy also negatively affects the health of the fetus, the baby experiences hypoxia. It is known that such a decrease in oxygen can lead to a delay in the development of the child.

At this stage of anemia, the doctor prescribes iron preparations, taking into account the individual characteristics of the pregnant woman's body. Hemoglobin levels cannot be increased by diet alone.

Anemia 3 (complex) degree (severity, stages)

The third or severe form of IDA is the most difficult and dangerous. Such anemia manifests itself as a decrease in hemoglobin to 70 g / l and below.

Anemia during pregnancy of the third degree is a very serious and life-threatening disease for mother and child. Doctors warn that this condition requires immediate hospitalization.

Severe anemia is one of the main causes of death for mothers and babies, as well as a factor in preterm birth. There is a threat for the development of oxygen deficiency, leading to fetal hypoxia. In the second trimester, there is a risk of developmental delay as a result of inadequate nutrient intake.

In special cases, in the third trimester there is a risk of intrauterine fetal death. With a low iron level, blood clotting is significantly reduced, which can cause bleeding. This poses a risk to the life of the mother.

Clinical manifestations of a severe form are expressed in different ways. But a complex form of anemia greatly affects the health and well-being of a pregnant woman. Exhaustion and general weakness are necessarily noted, fainting and dizziness, signs of intoxication are likely. You can also notice the disruption of the gastrointestinal tract and of cardio-vascular system.

A pregnant woman is subject to mandatory hospitalization and special therapy under the supervision of a doctor. The third degree of anemia is dangerous by the discharge of amniotic fluid and provoking premature birth.

Anemia of the fetus during pregnancy: why it occurs, the consequences for the child and the pregnant woman

For hematopoiesis human body vital iron. During pregnancy, the need for iron doubles.

When registering with a antenatal clinic for pregnancy and during the entire pregnancy the doctor is obliged to control the level of hemoglobin in the blood of the expectant mother. The first laboratory blood test for hemoglobin is given at registration, the next - in the second and third trimesters in the absence of problems.

If hemoglobin is slightly below normal, the doctor will help adjust the diet. With mild anemia, a pregnant woman is recommended to introduce foods high in iron into the diet. If hemoglobin is significantly below normal, then drugs that contain iron are prescribed. For their proper assimilation, it is necessary that there are no interruptions in the functioning of the liver and intestines.

Fetal anemia is diagnosed after 18 weeks of gestation by blood tests. obtained by cordocentesis. Anemia of the fetus can occur due to maternal anemia or as a result of Rh conflict, causing isoimmune hemolytic disease. In difficult cases, one has to resort to intrauterine blood transfusion through the abdominal cavity or into the vein of the umbilical cord.

Severe anemia is dangerous for both the baby and the mother. For a baby, anemia is fraught with the development of severe complications and can be life-threatening. In a pregnant woman, anemia causes not only a deterioration in well-being, but also causes serious harm to health. Severe anemia can cause preterm labor and cause bleeding.

It is worth clarifying that by the period of 32-34 weeks of pregnancy, a drop in hemoglobin is considered natural, and most often does not require special therapeutic measures. By the time of delivery, the concentration of red blood cells increases, and the transport of oxygen molecules is restored. Finally, the iron content returns to normal 3 years after birth.

How to treat anemia: drugs, drugs to increase hemoglobin, pills for pregnant women

Even a slight drop in hemoglobin requires control and attention from the doctor. The chosen method and method of treatment depends on the degree of anemia. Self-medication in anticipation of the baby is not worth doing.

Low hemoglobin during pregnancy: 1st trimester

For mild anemia attention is paid to the diet of a pregnant woman. You can correct hemoglobin if you add foods high in iron to the menu, you should pay attention to the activity of the intestines and liver, which are responsible for the production of protein - the main element in the synthesis of iron. Also mother-to-be is recommended to walk in the fresh air.

Low hemoglobin during pregnancy: 2nd trimester

Moderate anemia requires drug therapy. Only a doctor can prescribe it. The doctor selects iron preparations taking into account the individual characteristics of the body of the expectant mother, the collected anamnesis and the nature of the course of pregnancy. These medicines include: Ferroplex, Ferroceron, Kanefron and others.

Reception and dosage of an iron-boosting drug is prescribed by a doctor. Usually, after 2 weeks of admission, a control blood test is prescribed to see if an increase in hemoglobin is observed. For any side effects and if the drug is ineffective, the drug is canceled and replaced with other means.

Low hemoglobin during pregnancy: 3rd trimester

With a complex form of anemia, a pregnant woman is subject to hospitalization. Under the supervision of a doctor, special therapy is carried out, most often infusion. A woman is prescribed medicines and monitors the blood picture. In rare cases, they may resort to a blood transfusion from a donor or a transfusion of red blood cells.

In the third trimester, the second and third degrees of anemia require serious treatment due to the risk of preterm birth. It should be noted that for a period of 32-36 weeks, the hemoglobin level drops to a minimum. This is due to physiological characteristics. By the time of birth, he returns to normal. If this does not happen, prescribe medications.

When anemia is observed during pregnancy, that such a disease can be prevented by enriching the woman's diet with foods containing B vitamins, unfortunately, not many people know

In complex treatment, an important role is assigned to the reception vitamin complexes for pregnant women, which include: B12, folic acid, B6, E. With a deficiency of these vitamins, iron is not absorbed, and the treatment will not bring the expected effect.

The problem of anemia during pregnancy has long been known. Therefore, it is not surprising that such a phenomenon has caused a lot of popular recipes for how to quickly deal with the problem of low hemoglobin.

For anemia in pregnant women, traditional healers recommend the following recipes:

Daily for breakfast, eat grated carrots seasoned with sour cream or vegetable oil. Alternatively, you can start your morning with a glass of freshly squeezed carrot juice.
During the day, use an infusion of rowan fruits. For two teaspoons of dried fruits, you need 2 cups of boiling water. Rowan berries are infused for an hour, sugar is added to the resulting infusion to taste. Divide the resulting infusion into 3-4 doses.

An effective remedy to increase hemoglobin is the following composition: juice of radish, beets and carrots in equal parts pour into a container with a lid, and simmer in the oven at a moderate temperature for 3 hours. Take 1 tablespoon 3 times a day.

Traditional medicine recipes are recommended to be used only after consulting with your doctor. The expectant mother should understand that folk advice cannot replace full-fledged therapy for moderate and severe anemia, they can only be considered as auxiliary methods.

Is it possible for pregnant women with anemia to raise hemoglobin levels

Since childhood, many people know that a hematogen bar increases hemoglobin. Now various flavors and ingredients are additionally added to the bars. Pharmacies sell hematogen with chocolate, coconut, nuts, etc. You can find a bar for every taste, some even consider hematogen to be a useful substitute for sweets.

Hematogen is made from boiled bovine blood, which is rich in iron. But the hematogen, like all products containing iron, does not increase hemoglobin too significantly. It also requires a long intake of iron-containing foods. An increase in hemoglobin occurs, but at a low level, a large improvement in blood counts cannot be achieved only with the help of an iron-rich diet.

It is worth remembering that the norm of consumption of hematogen per day is not more than 50 grams for an adult and 20-40 grams for a child(depending on the age of the child and the manufacturer of the drug). 50 g is one bar!

It can cause an allergic reaction, which is more pronounced during pregnancy.
Promotes weight gain, tk. contains carbohydrates in an easily digestible form.
May cause nausea as side effect symptoms of fermentation in the stomach with the release of gases.
It has the ability to thicken the blood, which increases the risk of blood clots.

Be sure to read the fine print on the Hematogen packaging. Some manufacturers honestly write that pregnancy is a direct contraindication for taking Hematogen.

Of course, hematogen is one of the useful delicacies, but you should not take risks and eat it during pregnancy, especially since it is impossible to seriously raise the level of hemoglobin with this sweetness.

Low hemoglobin in the blood during pregnancy: how to increase iron levels, nutrition, diet

Anemia during pregnancy can develop due to various reasons, but there is no doubt that such a condition requires special control. The first thing a pregnant woman should do is adjust her diet. Expectant mothers need to include iron-rich foods in their diet(meat, liver, fish, buckwheat, etc.).

With anemia, you can not limit yourself in nutrition, and even more so starve. It is better to break the daily meal into 5-6 meals, and each of them must contain products with iron content.

Even if the expectant mother adheres to a vegetarian diet, then it is worth double diligence to pour on vegetables and fruits with iron content (carrots, cauliflower, apples, bananas, etc.). A high percentage of iron is found in legumes: peas, soybeans, lentils, red beans.

In most cases, it is impossible to greatly increase hemoglobin with food alone, so it would be appropriate to drink a complex of vitamins and trace elements with an iron content.

You can also take special iron preparations as directed by your doctor. They are designed in such a way that the iron that is part of them is absorbed by the body several times more efficiently than the iron that is part of conventional products.

Iron-Containing (Iron-Rich) Foods for Anemia: A Pregnancy List

As a preventive measure and to increase hemoglobin, pregnant women are recommended to include in their diet the following foods:

beef meat, chicken, turkey, beef tongue;
liver;
all types of fish;
white and rye bread;
eggs;
buckwheat porridge;
cottage cheese;
vegetable oil;
vegetables and fruits.

It is important to reduce the consumption of coffee and tea as much as possible., they contain a lot of tissue, which prevents the absorption of iron.

All products that adversely affect the functioning of the liver can play a negative role: iron will not be absorbed even from useful products.

Therefore, the diet should be as balanced as possible, and its ingredients should be of natural origin.

How to eat, what to eat and drink to prevent anemia during pregnancy

What is anemia during pregnancy for every woman planning to become a mother, the doctor will explain in detail. In order to prevent in the early stages, the LCD will help you choose a balanced diet. The joint efforts of the doctor and the pregnant woman can avoid the development of a disease that poses a threat to the development of a new life.

Sample menu for the expectant mother for the day

Breakfast:

grated carrots with low-fat cottage cheese;
2 hard-boiled eggs;
herbal tea.

2nd breakfast:

baked beet or apple;
a piece of hard cheese;
rosehip decoction.

Dinner:

vegetable soup;
buckwheat with fried beef liver;
compote;
fresh apple.

Afternoon snack:

kefir or yogurt;
fruits fresh or dried.

Dinner:

vegetable stew or braised cabbage with meat;
herbal tea.

From the diet it is necessary to exclude all harmful products(salted, fried, canned, fast food, etc.). It is better to exclude black tea, coffee, limit dairy products (except cottage cheese and kefir), they do not contribute to the absorption of iron in the body.

Anemia during pregnancy is a common and serious phenomenon. To prevent such a disease from affecting you, periodically take tests, control your hemoglobin level, monitor your diet and listen to the recommendations of doctors.

Video about anemia during pregnancy and its treatment methods

Video about anemia during pregnancy - what is it:

Video with Dr. Komarovsky about the danger of a decrease in hemoglobin for a child in pregnant or lactating women:

Anemia during pregnancy, or anemia, is a confirmation that at the time of the development of the child, the female body spends a huge amount of red blood cells and iron on the formation of the fetus.

During pregnancy, 90.0% of all types of anemia are anemia with iron deficiency.

What is hemoglobin and red blood cells

Hemoglobin has a red color, which gives a red tint to the erythrocyte. Hemoglobin plays an important role in the transport of red blood cells throughout the human body. The body receives nutrition for every cell. Also, through the placenta, nutrients in utero enter the fetus.

Hemoglobin and red blood cells

Kinds

Anemia is classified according to the cause of its occurrence in 3 groups:

Anemia of the posthemorrhagic group it is a pathology that provoked a profuse loss of blood,
Anemia, which was formed on the basis of pathology in the synthesis of DNA and RNA molecules in the bone marrow,
Group of hemolytic pathology This is a disease that develops under the influence of the destruction of red blood cells.

Anemia caused by malnutrition:

Iron deficiency type low iron in the body, which is important for the synthesis of red blood cells and hemoglobin,
Folate deficiency and anemia with a lack of vitamin B12 provoked by a lack of protein in the diet.

Pathology provoked by the destruction of erythrocyte molecules:

Anemia hemolytic caused by a hereditary factor. This is when the process of producing red blood cells is slower than the destruction of red blood cells.

sickle cell This is anemia caused by malfunctions in the production of hemoglobin. Molecules are produced with a defect. Defective molecules cause the erythrocyte molecule to stretch and give the molecule a crescent shape.

The sickle-shaped molecules become inelastic, resulting in a thick biological fluid, the sharp tips of these red blood cells pierce each other, causing death.

Thalassemia develops due to a low rate of hemoglobin synthesis. Unripe hemoglobin does not have stable characteristic properties and settles in the molecules of erythrocytes in the form of bodies.

An erythrocyte with this pathology has the form of a target molecule.

A disease that is caused by the synthesis of erythrocyte molecules:

aplastic anemia,
Posthemorrhagic anemia.

The development of anemia, as a complicated form of pathologies of the body:

Anemia associated with liver disease
The consequence of malignant neoplasms in the internal vital organs,
Diseases in the genital area.

Classification of iron deficiency anemia during pregnancy

The degrees of anemia are divided depending on the hemoglobin index in the biological fluid and on the course of the disease:

Degree of anemia Presence of hemoglobin

Anemia as a contraindication to pregnancy

Not every woman is able to bear a healthy child, and a woman who suffers from anemia has the risk of not only losing the baby, but also putting her life in danger.

Pathologies in which it is dangerous to conceive and bear a baby:

Anemia with iron deficiency, which occurs in a chronic and severe form,
Aplastic anemia (bone marrow stops producing blood in the right amount),
Anemia, which is complicated by leukemia,
Anemia disease associated with Werlhof's disease.

Such severe forms of anemia are very rare, but if the question arises of artificial termination of pregnancy, then this decision is made no later than after the 12th calendar week of intrauterine fetal formation.

Anemia in a pregnant woman is an acquired condition of the body, but during pregnancy it complicates the course of intrauterine development of the baby.

Hemoglobin norms by gestational age

The hemoglobin index in the blood of a pregnant woman should be at least 110.0-140.0 g / liter. This level should be at all stages of pregnancy.

If in the 1st trimester the index reaches 140.0 g / l, then by the 2nd trimester it decreases and reaches 120.0 g / l. The 3rd trimester is the most expensive period for the female body. In this trimester, a woman will spend the largest amount of all nutrients on the development of her baby. Hemoglobin in the 3rd trimester is from 110.0 to 115.0 g / l.

How does the development process take place?

The female body has to intensively produce red blood cells in larger quantities, and more hemoglobin is also needed. If an insufficient amount of vitamins enters the body of the expectant mother, then there is a lack of material for the synthesis of red blood cells.

The index of these molecules decreases and the hemoglobin coefficient also decreases.

If the hemoglobin coefficient has decreased to 110.0 g / l, then we can talk about a deviation in the normative indicators of red blood cells during pregnancy.

The reasons

Factors that contribute to hemoglobin deficiency:

Avitaminosis,
Not enough food consumed
Unbalanced diet, starvation,
Failure in the hormonal system,
Use of hormonal contraception,
Diseases in the genital area,
Chronic pathologies of the liver,
Diseases of the heart muscle
Rheumatism,
Problems in the functioning of the kidneys,
disease of the pancreas,
Diabetes,
Nosebleeds that have a chronic stage,
Large volume of menstrual blood output,
Early age for pregnancy
Pregnancy at a later age (after 30 calendar years),
woman smoking,
Regular consumption of alcoholic beverages
Polyhydramnios in a pregnant woman
Carrying 2 or more children at the same time,
hereditary genetic predisposition,
Short term (less than 4 calendar years) between pregnancies.

There may be external provocateurs, this is intoxication of the body, which is associated with work activity, and is systematic.

In the pathology of the body, the entire supply of iron accumulates in the area of the focus of the disease, and the rest of the organs feel its deficiency.

Over the entire duration of pregnancy, a woman loses 900.0 milligrams of iron. In order to fully restore it in the body, you need a long time.

Signs of anemia during pregnancy

Signs of anemia during pregnancy are anemic, which are associated with the general condition of the body and sideropenic, associated with iron deficiency.

Anemic symptoms are manifested as follows:

The skin is dry to the touch and there is a process of exfoliation of the epidermis in it,
The state of weakness in the body,
Constant desire to sleep
Spinning of the head, sometimes severe and causing a state of fainting,
Low blood pressure index (hypotension),
Shortness of breath on exertion and when relaxed
Muscle tone is weak.

Sideropenic signs are:

Also, with severe anemia, symptoms of cardiovascular disease appear.

Why is anemia dangerous during pregnancy?

Anemia in a pregnant woman can lead to serious consequences, dangerous complications in the birth process and pathologies of fetal formation.

Complicated anemia during pregnancy:

Experts believe that the cause of frequent colds in young children is the consequences of complicated anemia during pregnancy. Also, anemia in the expectant mother provokes allergies in the baby in 30.0% of cases of allergies in children.

Consequences for the child

Anemia in a pregnant woman can cause complications during the period of intrauterine fetal formation and provoke pathologies in a born baby:

Low weight newborn
Retardation in physical formation,
Baby's umbilical cord heals slowly
Anemia after childbirth
Delayed development of the child's motor skills,
Deviations in mental development,
Low immunity.

Gestational form

Gestational anemia affects up to half of pregnant women. The gestation period (the entire period of pregnancy) occurs when a fertilized egg enters the uterus.

This form of anemia is associated only with the process of pregnancy. If a woman has developed anemia before the time of gestation, then she does not apply to this form.

With this form of anemia, there is a violation in the fixation of the fetus in the placenta. It is caused by hypoxia of the placenta. The development of the fetus during the 1st trimester begins in the upper layer of the uterus. 2 semester there are changes in the formation of the fetus.

The small capillaries of a pregnant woman burst from the load, and the child suffers even more from hypoxia.

Anemia due to iron deficiency

The stock of this substance is deposited in the cells of the liver, in the cells of the spleen and stored in the bone marrow. The loss of iron by the body occurs constantly, this is at the time of urination (with urine), with feces, with sweating.

Iron deficiency anemia during pregnancy provokes most of the complications. Increased consumption of hemoglobin by the body, increases iron deficiency. In order to constantly replenish iron, it is necessary to replenish it with the right diet and medicines prescribed by doctors.

With reduced hemoglobin, which is caused by iron deficiency in a child, oxygen starvation may occur, since nutrients and oxygen will be transported uninterruptedly.

Hypoxia is the first provocateur of abortion and premature birth.

Causes of iron deficiency during pregnancy:

Increased need of the body, with little compensation,
Pathology in the intestines, in which iron is not fully absorbed.

Diagnostics

Identification of iron deficiency anemia is carried out by laboratory study of the composition of the blood.

Confirmation of the diagnosis of iron deficiency anemia in a pregnant woman is when the following indicators are in the test results:

The presence of hemoglobin indicators is practically absent,
Hemoglobin index reduced to 60.0-70.0 grams per liter of blood,
Erythrocytes are low 1.5 2.0 t/l,
Erythrocytes of various atypical forms appeared in the blood composition.

Erythrocytes: a - normal (discocytes), b - target-shaped (platycytes), c - stellate (acanthocytes), d - sickle-shaped (drepanocytes), e - semilunar (meniscocytes), f - ragged (schizocytes), g - mouth shapes (stomatocytes ), (h) oval (elliptocytes), and (i) spherical (spherocytes).

Anemia folate deficiency and B12 deficiency

With a small amount of B12 and folic acid in the body, deviations from the normative indicators occur in the synthesis of bone marrow cells.

This type of anemia is on the same position in the group of pathologies of anemia, along with anemia, which is caused by iron deficiency in the body. This group of diseases is caused by diseases that are in the chronic stage.

Deficiency of this substance provokes malnutrition and the absence of animal products in his diet in sufficient quantities: meat products, especially red meats, liver and liver, dairy products and eggs.

Replenishment in the body of B12 and folic acid molecules must go constantly, since this vitamin is lost during the daily physiological processes of the release of the intestines and bladder.

Causes of vitamin B12 and folic acid deficiency:

Detection through diagnostics

According to the results of a general analysis of blood composition, the following indicators are noted:

The quantitative index of erythrocytes is lowered,
Large erythrocytes,
Color level not less than 1.1,
Hemoglobin index is low,
Poor quality of erythrocytes in the molecules are the remains of the nucleus,
Low reticulocyte count
Low neutrophil count,
Decreased platelet count
Deviation from the norm towards a strong increase in all cells.

Diagnostics

Diagnostic study begins with a general examination of the pregnant woman. It is also necessary during pregnancy to take regular urine and blood tests.

According to a blood test, it is determined:

hemoglobin index,
The number of erythrocytes,
Leukocytes,
Hemocrit in the blood.

If, according to the result of the blood test, deviations from the norm are revealed, then the attending doctor directs for additional studies:

Ultrasound examination of the kidneys,
Ultrasound of the stomach and intestines.

If all coefficients indicate anemia, a biochemical analysis is performed to study the causes:

Serum iron concentration
The degree of ability to bind iron molecules to serum fluid, for transferrin (protein transport).

How to treat anemia during pregnancy

Therapy of anemia during pregnancy takes place in accordance with the form of anemia and the stage of development of the pathology.

1 degree of anemia in pregnant women is treated with a diet.

All medicines are prescribed by a doctor who controls anemia during pregnancy, and also adjusts the treatment regimen. In addition to drugs for anemia, you need to take medicines to treat comorbidities.

Medicines for anemia:

Ferroplex,
Ferrocal,
Tardiferon with folic acid,

Medical therapeutic course up to 6 calendar months. After childbirth, if there is a question that anemia is present in the body, then therapy must be continued.

Diet for anemia

In order to make up for the deficiency of anemia in the first stage of pregnancy, it is necessary to follow a diet with a high content of iron in foods.

meat - veal, chicken, beef liver, tongue,	meat - lamb, fatty beef, pork,
fatty fish - mackerel, sturgeon family,	· animal fat,
cereals - buckwheat, millet, barley,	Foods containing trans fats.
fresh vegetables - tomatoes, red beets, cabbage of all kinds, carrots,
garden greens - spinach, parsley, dill,
berries - gooseberries, black and red currants, raspberries, strawberries,
fresh fruits - green apples, plums, peaches, persimmons,
natural honey.

Preventive actions

To prevent the pathology of anemia, you need to take a complex of vitamins for the period of pregnancy, which contains no less than 60.0 milligrams of iron, as well as 250.0 μg of vitamin B9 (folic acid).

The scheme of the therapeutic course is prescribed by the attending doctor. Self-medication during pregnancy is fraught with abortion or the birth of a defective child.

Importance of vitamins during pregnancy

Preventive measures for anemia in expectant mothers should begin from the childhood of girls.

The function of vitamins for the female body is very important:

Vitamin C it is an antioxidant that strengthens the protective functions of the body and helps the absorption of iron,
Vitamin E it is a protector of the placenta during pregnancy from external factors,
Vitamin B 9(folic acid) is necessary for the prevention of anemia,