Rus Articles Journal

Pregnancy and anemia of

What is anemia?

In the people anemia is called an anemia. From this, of course, does not follow that at the patient with anemia really blood has less, than at the healthy person. Anemia is a reduction in blood of amount of hemoglobin. Of course, there are situations when the content of hemoglobin falls as a result of sharp blood loss, but in most cases it is about decrease in level of hemoglobin in blood unit of volume (i.e. the total amount of blood normal, and the content of hemoglobin - is lower than norm). Together with hemoglobin at anemia also the quantity of red blood cells - erythrocytes decreases usually. Normal content of hemoglobin at women 120 - 160 g/l, erythrocytes - 3,4 - 5,0 million / mkl are considered.


Most often (in 90% of cases) diagnoses iron deficiency anemia - a state at which in an organism there is not enough one of the main components of hemoglobin - iron. Many and out of pregnancy have its hidden deficiency. In a midland of Russia, including in Moscow, deficiency of iron is found in 15% of women.

Developing of anemia is connected by

with a variety of reasons. One of them consists that digestive organs cannot how many ferriferous products of people ate, soak up more than 2 mg of iron a day. With then, urine, the dropping-out hair, the peeling epithelium of skin it is brought out of an organism in days of 1 mg of iron. Women in childbearing age for days of periods lose 40 - 50 mg (some to 60 mg), and 20% of women - more than 60 mg of iron. With food for these days only 20 mg of iron arrive.

Deficit of 30 mg is restored by

from stocks (depot) of an organism on average in a month - in an interval from one menstrual cycle to another. The total of iron which has to is in depot, - 4 g. During pregnancy, childbirth, breastfeeding 0,6 - 0,7 of iron is spent. It is required not only mothers, but also to a children`s organism.

What is anemia of pregnant women?

So-called indicators of red blood - the amount of hemoglobin, erythrocytes, iron - decrease even at healthy pregnant women. It is natural and connected with the fact that the volume of different components of blood increases during pregnancy in a different measure. The plasma volume (liquid part of blood) increases more, than the volume of erythrocytes. There is as if a cultivation of erythrocytes (namely the dense part of blood generally consists of them) in a large amount of liquid. At the same time the absolute quantity of erythrocytes remains normal, and specific (in blood unit of volume) - decreases. Such state is called a gidremiya. Gidremiya and anemia (anemia) - different things.

However it is frequent at pregnant women true anemia develops. Moscow, St. Petersburg and many other cities of Russia reveal it at 40% of future mothers. In the different countries the frequency of developing of a disease among pregnant women fluctuates from 21 to 80%.


various factors contribute To development of anemia in pregnant women. Often the reasons are covered in violation of absorption of iron in intestines, in bleedings from zheludochno - an intestinal path (at hemorrhoids, for example), in prelying of a placenta. Provoke an anemia the vomiting caused by toxicosis, mnogoplody (twins, triplets etc.) some chronic diseases (hepatitis, pyelonephritis and others). Anemia often is found in the winter and in the spring when in food there are not enough vitamins.


On blood formation the great influence is exerted by sex hormones. Man`s (androgens) strengthen iron absorption, and women`s (estrogen) slightly brakes. Therefore at teenage age, during formation of sexual function, girls quite often have an anemia which can be transformed further to iron deficiency anemia of pregnant women. Most often this disease diagnosed in early terms of pregnancy existed even before its emergence. The anemia connected directly with pregnancy develops, as a rule, in its second half.

Future mothers, besides iron deficiency anemia, suffer from a time and anemia of other nature: megaloblastny (deficiency of 12 vitamin B or folic acid), hypoplastic (oppression of marrowy blood formation), hemolytic (the congenital or acquired autoimmune). The reasons, a clinical picture of an illness, treatment, the forecast at them are various and individual. Having such diseases need supervision of the hematologist from early terms of pregnancy and if the disease was for the first time shown during pregnancy, then at detection of its first symptoms.


As shows and diagnosed anemia?

Some it do not feel

at all, and therefore can not show to the doctor any complaints. Others are disturbed by weakness, short wind, dizziness, faints. Quite often there are also trophic changes connected with deficiency in an organism of the enzymes containing iron. Then the hair loss, fragility of nails, cracks in mouth corners are observed, yellowness of palms and a triangle near by, perhaps involuntary urination and depletion of intestines, exotic gastronomic addictions - desire is chalk, an eraser, to smell liquids with pungent smells. At heavy anemia heart failure with tachycardia, hypostases, lowering of arterial pressure can develop.

Blood tests at true anemia find less than 110 g/l of hemoglobin, the color indicator less than 0,95, the level of iron of serum of blood is less than 10 mmol/l.

Doctors say that anemia proceeds benign, at the content of hemoglobin of 90 - 110 g/l; it is about average weight of anemia at the level of hemoglobin of 80 - 89 g/l, heavy anemia is considered if the amount of hemoglobin is less than 80 g/l.


What anemia is dangerous during pregnancy?

For mother
Anemia promotes development of various complications of pregnancy. Toxicoses at the pregnant women having anemia develop by 1,5 times more often than at healthy women. In particular, gestoz which is followed by hypostases the protein in urine raised by arterial pressure diagnose approximately for 40% of the pregnant women sick with anemia, abortions, premature birth - for 15 - 42%. More often complications in labor develop.

For the child
by a year of life too quite often find deficiency of iron In children whose mothers during pregnancy had anemia. Children of the first year the lives which were born at women with anemia of pregnant women get sick with a SARS much more often, at them the probability of development of an enterokolit, pneumonia, different forms of an allergy is much higher (including diathesis).

How to prevent anemia of pregnant women?

At some women can expect development of anemia during pregnancy: at those who were ill before it, have chronic diseases of internals, at repeatedly giving birth women and also if at the beginning of pregnancy the content of hemoglobin in blood did not exceed 120 g/l. In all listed cases preventive treatment is necessary. Doctors usually appoint an iron preparation which is recommended to be accepted within 4 - 6 months since 15 - y weeks of pregnancy.

As does not need to treat anemia of pregnant women?

In treatment of anemia at pregnant women an important role is played by a diet. Wrong idea that it is necessary to eat mainly vegetables and fruit, “containing iron“ (apples, especially antonovsky, pomegranates, carrots) is widespread. Actually the emphasis has to be placed on meat products. You judge: from meat 6% of iron, and from vegetable food - only 0,2% are soaked up.

Some consider that the meat which underwent processing loses part of the useful properties, and prefer to eat, for example, a crude liver. It not only is not useful, but also it is dangerous. The crude liver can be a salmonellosis source.

Besides, it must be kept in mind (it for those who are afraid to take a pill): deficiency of iron cannot be liquidated only food. From them no more than 6% of iron, and from drugs - 30 - 40% are soaked up. Of course, food by the patient with anemia is required various, full (it by all means has to include vegetables and fruit, vitamin-rich), but to reject as the excessive preparations of iron registered by the doctor it is impossible at all!

It is senseless also to try to liquidate deficiency of iron, ignoring ferriferous preparations, - such means as antianemin, polyvitamins, copper preparations.

How to treat anemia of pregnant women?

the set of preparations of iron Exists, and any of them does not make harmful effects on a fruit. And here from the point of view of their influence on a condition of the most pregnant woman not all from them it is possible to call harmless. The means which are available on sale strongly differ on percentage of iron, the range and amount of additional ingredients, and not all pregnant women equally well react to all preparations. So, ferrotseron it is capable to cause dyspepsia, urination violation. Therefore if there is a possibility of the choice, it is better for them not to use. And ferrokal, as well as ferropleks, have insignificant side effects and, as a rule, are well transferred by pregnant women. Both of these preparations are recommended to be applied in quite high doses: on 2 tablets 3 - 4 times a day.

Konferon containing more than iron (it, by the way, can also cause dyspepsia), it is necessary to accept in smaller doses: 1 capsule 3 times a day. Tardiferon and gino - tardiferon (folic acid, useful to a fruit is added to the last) to accept on 1 tablet a day with preventive and 2 tablets enough - with the medical purpose. Appoint iron preparations most often for intake - in tablets or capsules. Injections have no advantages, but are fraught with complications. At intravenous administration development of a state of shock, violations of the curtailing system of blood is possible, at intramuscular - infiltrates, abscesses in places of injections. Doctors appoint injections only in some cases when there is a violation of absorption of iron in zheludochno - an intestinal path, at diseases of the digestive system, intolerance of preparations of iron (nausea, vomiting), an exacerbation of stomach ulcer of a stomach or duodenum.

Treatment of anemia is usually long

. Level of hemoglobin increases, as a rule, by the end 3 - y weeks of administration of drugs, this indicator still later - in 9 - 10 weeks is normalized. At the same time the health of the patient improves quickly.

it is Very important not to stop in such cases treatments. Pregnancy with its increased requirements to an organism of the woman continues, childbirth with inevitable blood loss is coming, the long period of feeding of the child a breast - all this can cause recurrence of anemia. Therefore the supporting therapy is recommended by iron preparations within 3 months: 1 tablet 1 - 2 times a day. But also it is not all. During the postnatal period it is necessary to accept the same dose of 6 more months.

If during pregnancy did not manage to achieve treatment of anemia, then after the delivery it is necessary to conduct annually within a month a full-fledged course of reception of medicines before normalization of a state.

Iron deficiency anemia treat mainly on an outpatient basis. Only in hard cases hospitalization is required. This form of anemia is not contraindication for pregnancy.