Anemia in Pregnancy
Aka: Anemia in Pregnancy, Postpartum Anemia, Iron deficiency in Anemia in Pregnancy
II. Pathophysiology
- Hemoglobin levels change during pregnancy
- Wanes in second trimester due to hemodilution
- Increases in third trimester
- Falls with delivery with placental separation
- Anemia in Pregnancy most often nutritional deficiency
- Folic Acid Deficiency (Megaloblastic Anemia)
- Protein Deficiency (Malnutrition)
- Iron Deficiency Anemia
III. Labs
- See Hemoglobin Cutoffs for Anemia
- See Iron Deficiency Anemia
- Hemoglobin Cutoffs
- First Trimester: 11 g/dl
- Second Trimester: 10.5 g/dl
- Third Trimester: 11 g/dl
IV. Management
- Hemoglobin 10 to 12 mg/dl
- Ferrous Sulfate 325 mg qd for 2 months
- Hemoglobin 9 to 10 mg/dl
- Ferrous Sulfate 325 mg bid for 2 months
- Hemoglobin 7 to 9 mg/dl
- Ferrous Sulfate 325 mg tid for 2 months
- Hemoglobin <7 g/dl
- Consider transfusion
- Hemoglobin <6 g/dl
- Transfusion to prevent adverse fetal outcome
V. Prevention
- Prenatal Vitamins daily