iron requirements increase during pregnancy (mother needs 1000 mg of elemental iron per fetus; this amount exceeds normal stores) f...
iron requirements increase during pregnancy (mother needs 1000 mg of elemental iron per fetus; this amount exceeds normal stores)
- fetus (500 mg)
- RBC mass (500 mg)
- losses (200 mg)
Etiology
- inadequate iron intake
- iron malabsorption
- bleeding, vaginal or other source
- multiple gestation
- concurrent antacid use (may prevent iron absorption)
Complications
- maternal: angina, CHF, infection, slower recuperation, preterm labour
- fetal: decreased oxygen carrying capacity leading to fetal distress, IUGR, low birth weight and hydrops
- CBC, blood film, serum ferritin (changes in ferritin stores first sign of anemia)
- microcytic, hypochromic anemia with decreased ferritin
- morphology not good indicator because of RBC half life
- TIBC not reliable because increased during pregnancy
- Prevention :
- dietary iron and iron mobilized from stores insufficient to meet demands
- adequate iron intake (30 mg elemental iron/day) for all women
- oral supplement of 200 mg/day of elemental iron if anemic
- monitor
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