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Abstract
Healthy pregnancy is associated with marked changes in the circulating blood. These physiological changes include increase in the blood volume and alteration in the interacting factors involved in hemostasis. The plasma volume increases progressively from 6-8 weeks of gestation and reaches a maximum at approximately 32-34 weeks. The increase in plasma volume is relatively greater than that of red cell mass resulting in hemodilution and decrease in hemoglobin concentration. This has been termed the ”physiological anemia of pregnancy”. The total leukocytic count increases during pregnancy. Platelet count declines during pregnancy apparently in a direct relation to increased plasma volume.
Obstetricians commonly encounter anemia during pregnancy. Confusion exists in making the diagnosis due to physiologic changes that occur during pregnancy. About 8% to 10% of women of reproductive age are anemic.
The commonest hematological problem in pregnancy is anemia resulting from iron deficiency mostly due to the increased utilization of iron or inadequate intake of it in the diet. The incidence of iron deficiency anemia is lower in women who take oral iron supplementation. In iron sufficient women, the administration of 30 to 60 mg of elemental iron per day is adequate, but 200 to 300 mg is necessary in iron deficient pregnant women. Oral iron should be continued at least 6 months after delivery to adequately replenish iron stores which is measured by serum ferritin.