#73 Anemia of Pregnacy

One of the first and most important adaptations of mothers to pregnancy is the enlargement of the intravascular space, often called the container. This change is often accompanied by lower blood pressure because the container is bigger, but the contents are not. Over time, the intravascular volume increases to fill the bigger container.

The larger container and the larger volume are some of the most important adaptations in pregnancy. These conditions create a relative anemia because the blood volume increases first, while the hemoglobin takes about three months to be made. This creates a relative anemia, which is most common in the second trimester.

Most women will run a Hgb between 13 and 15 when they’re not pregnant, but a hemoglobin between 12 and 13 is better for pregnancy. Return of hemoglobin to 14 or 15 in pregnancy is a sign of impending preeclampsia. So, not only is a relative anemia common, it is essential for a successful pregnancy.

There are conditions in which people can develop pregnancy anemia in the face of a pre-existing anemia. There could be several causes. Certainly, heavy bleeding with a low iron level preceding pregnancy would be a common problem. There are several inherited conditions which would be associated with anemia before a pregnancy, such as sickle cell anemia.

Feeling weak, faint and nauseated from time to time are all part of normal pregnancy symptoms. These symptoms most often result from low blood pressure associated with a larger blood volume and lower hemoglobin. all which normal and healthy responses to pregnancy.

If you are having trouble with the symptoms of low blood pressure, be careful to allow time when standing up from a sitting or lying position. Allow yourself some time to adjust and be careful in the shower. I’d recommend walking around a little bit and having breakfast before your shower.

There are several ways to address the anemia of pregnancy. Remember, iron comes from red meat. Iron also comes in red vegetables and fruit. For example, radishes, apples, grapes, prunes, plums, and dates. Diet alone might be a challenging way to get the iron you need. Many prenatal vitamins have some iron, and they’re also iron only vitamins, which have iron sulfate or iron gluconate.

While the iron gluconate is more tolerable, it is also absorbed more slowly. Taking oral iron can present problems like constipation, which can occur in pregnancy anyway. Another problem with iron supplements is that they may cause nausea. You may want to consider taking the iron pills around 9 pm or an hour before bedtime. But remember if you take them right at bedtime, nausea, might keep you awake. Raising blood iron levels can be done relatively quickly with IM or IV Iron. Just remember, your body’s ability to manufacture hemoglobin will still require three months time even with a full body supply of iron.

Preventing anemia depends on the degree of anemia you have, why you have anemia, and what your blood stores of iron are. If you have anemia with a hemoglobin of seven or eight, it could be bleeding because you’re not making enough blood or because you’re losing too much blood. A hemoglobin of seven or eight is not normal in pregnancy. You will need a thorough workup from your physician, including looking for inherited blood diseases such as sickle cell anemia or bleeding tendencies. If your hemoglobin is low because you’re losing blood, your doctor will need to find a reason for your anemia. Remember, it’s not just a matter of raising your hemoglobin. It is a matter of determining why it is low. An accurate diagnosis is necessary.

To summarize the normal anemia in pregnancy, the container or the space inside of your blood vessels relaxes and enlarges. The next step is for this space to be filled up with serum, a straw-colored protein mixture while your body is creating red blood cells. After about three months, the red cells construction is complete, and they begin to be added back into the expanded blood volume. During the time that is required to build the hemoglobin, anemia forms and can get down to 11. In pregnancy, this is normal. Once the red cells are made, the hemoglobin will then rise to somewhere around 12, which is normal in pregnancy.