Anemia in pregnant women by degrees. Iron deficiency anemia during pregnancy: causes and symptoms, treatment, list of iron supplements

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Anemia or anemia is a condition characterized by a deficiency of hemoglobin in the body. This occurs due to a decrease in the number of red cells (erythrocytes) during pregnancy. Today this is a common complication in pregnant women.

Iron deficiency with polyhydramnios on hemoglobin
If you have anemia, head massage, consult a doctor
Treatment Mouthwash

Pregnancy is a condition when great stress is placed on a woman’s body. Decreasing the immune system, a hormonal imbalance occurs. Anemia is also caused by a change in vitamin balance, a decrease in the amount of enzymes and microelements in the body.

The main reason is a decrease in hemoglobin by less than 110 g/l and insufficient iron content in the body. Another cause of the disease are factors that could have existed before pregnancy:

chronic alcoholism;
frequent cases of bleeding;
gynecological diseases (fibroids, endometriosis, etc.);
heavy or prolonged menstruation.

Anemia during pregnancy can develop in a woman with polyhydramnios, taking hormonal drugs or for chronic diseases.

The cause may be iron deficiency

A woman’s diet plays a very important, negative role, where the diet contains little variety of foods and vitamins.

The disease can be divided into several classifications - iron deficiency, acute, chronic, post-hemorrhagic. The cause is depleted iron reserves, numerous blood losses, chronic diseases, and pathologies in the gastrointestinal tract.

The folic deficiency form is caused by insufficient intake of vitamins B12 and folic acid into the body. Due to this, the synthesis of DNA and RNA is disrupted.

Hemolytic anemia during pregnancy occurs due to cold intolerance. It can also be hereditary and caused by infectious diseases. All about .

Posthemorrhagic anemia is caused by trauma, surgical intervention, blood loss, chronic or long-term diseases.

Factors causing aplastic anemia are radiation, interaction with chemicals, antibodies produced by bone marrow cells.

There are also three stages of the disease.

First degree, mild. When anemia first develops, a woman does not feel any discomfort. The sooner she starts treatment, the fewer consequences there will be for her during pregnancy and her baby.
Second degree of moderate severity. When the second degree begins, the pregnant woman begins to experience unpleasant sensations; the lack of iron affects her health and appearance.
Third degree, the most severe. This stage requires immediate inpatient treatment. The degree of risk can threaten the health of the expectant mother and baby.

Main signs of the disease

As mentioned earlier, at the initial stage of development of the disease there are no signs or pronounced symptoms. The disease can only be determined by test results. This is why it is so important to undergo routine examinations.

Starting from the second stage, symptoms may be as follows:

frequent fainting;
rapid pulse;
easy fatigue;
frequent dizziness;
general weakness of the body;
irritability, sudden changes mood;
pain in the thoracic region;
memory impairment, absent-mindedness;v
involuntary urination;
dyspnea;
change in the taste perception of food - parageusia;
changes in the functioning of the digestive organs.

May appear due to polyhydramnios

Anemia during pregnancy is also displayed on appearance women:

palms begin to peel and turn yellow;
cracks appear on the lips;
nails become brittle;
hair begins to fall out;
swelling of the legs appears;
the skin turns pale.

Consequences for the child and treatment

Consequences of anemia during pregnancy that can happen to the unborn child:

perinatal mortality rates are increasing;
hypoxic brain injury in more than 35% of cases;
fetal growth retardation (FGR);
development of infectious and inflammatory diseases in more than 37% of cases;
hypoplasia – underdevelopment of the amnion, chorion;
primary placental insufficiency (PI);
placenta previa;
low placentaria (placental attachment);
the risk of miscarriage increases;
discharge of amniotic fluid;
stillbirth;
premature birth, spontaneous miscarriage;
During childbirth, asphyxia may occur in the newborn;
fetal anemia.

Anemia of the 1st degree during pregnancy is well treated with non-drug methods:

following a diet that should contain many useful elements, including protein and iron;
recommend using therapeutic nutrition In order to increase the protein content in the body, it is necessary to consume products such as hematogen.

The main stages of treatment in hospitals are as follows:

restoration of normal hemoglobin content in the body in order to relieve anemia;
restoration of the main source of iron reserves in the body;
Maintenance therapy is aimed at maintaining all sources of iron (in order to restore deficiency in mild anemia, the average daily dose of iron should be from 60 to 100 mg; for more severe disease, a woman during pregnancy should adhere to a daily dose of 100 to 120 milligrams beneficial substance).

In a condition where iron absorption is impaired, or if a pregnant woman has a severe form of anemia and requires adjustment of the level and immediate replenishment of iron deficiency in the body, hospitalization is necessary.

Donate blood for hemoglobin

The administration of iron supplements through an IV is prescribed if the woman is intolerant to the drugs she is taking.

Application of traditional medicine

Often the treatment of a disease involves taking medications, but during pregnancy little is allowed, and some resort to using alternative medicine, including for the treatment of anemia.

In any case, before using one method or another, you need to consult a specialist and find out if there are any allergic reactions to the main ingredients.

For the first recipe you will need:

carrot;
beet;
radish;
container (preferably dark, glass).

Mode of application.

Grate the root vegetables on a fine grater.
Squeeze out their juice.
Pour everything into a bottle.
Close loosely (to allow liquid to evaporate).
Place in the oven for 3 hours on low heat.
Take one tablespoon several times during the day before meals for at least three months.

Need to eat more vegetables

To prevent and treat gestational anemia, a woman during pregnancy must use the second recipe. Required ingredients:

oats;
milk;

Mode of application.

Pour water over oats (5 tbsp/1 tbsp), boil until thick jelly.
Strain the resulting broth, add the same amount of milk (about 3 cups).
Boil again, add 4 teaspoons of honey to the resulting mixture and boil.
Take warmed or chilled. Use within one day.

For the third recipe you will need:

sagebrush;
vodka.

Mode of application.

Fill a jar (1 liter) with dry wormwood herb.
Pour in vodka (diluted pharmacist's alcohol will do).
Let it brew for 3 weeks in a dry, dark place.
Take the tincture once a day for three weeks in a row.
Take a break for 2 weeks and repeat the course again.
When taking, dilute 1 drop of tincture in a thimble of water.

Danger from inaction

The discovery of iron deficiency anemia in a woman during pregnancy greatly complicates the process of pregnancy and childbirth.

Pregnancy with anemia has the following consequences:

Early toxicosis is often observed in women;
development of gestosis;
risk of miscarriage;
arterial hypotension;
fetal pathology;
weakness of labor;
severe bleeding during and after childbirth;
a woman may develop hypogalactia;
every 3 children born to a woman who suffered anemia during pregnancy often suffers from respiratory diseases, and many have allergies.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

Today, anemia is a fairly common pathological process. With timely diagnosis and proper treatment, it does not pose a threat to either the mother or the child. Therefore, it is very important to understand and understand characteristic features and methods of treatment of this disease.
Content:

Etiology and extent of the disease

Scientists have proven that during the period of gestation of a fetus and breastfeeding, the female body loses from 800 to 1200 mg of iron. Therefore, the systematic replenishment of the body with this microelement through vitamin complexes or food. A competent approach to pregnancy planning will help avoid the development of this pathology in female body.

Risks for mild anemia during gestation of a fetus

Pregnancy is a special condition of the female body, characterized by the presence of a developing embryo or fetus in the reproductive organs. In this condition, the woman’s body is subjected to great stress, which contributes to a decrease in immunity and the development of hormonal disorders.

In most cases, 30% of women, during the period of gestation, due to anemia, are susceptible to complications that disrupt the normal functioning of all systems and internal organs. Changes occur in the functioning of the brain and heart, and the liver's production of proteins needed to create cells is limited.

Mild intoxication occurs both in the woman’s body and in the fetus. The intensity of blood flow decreases, the consequence of which is oxygen deficiency. Not timely treatment of this disease can provoke the development of the following pathologies:

Spontaneous
Threat of premature birth
Premature placental abruption
Leakage of amniotic fluid
Bleeding during labor
Hypotrophy of the intrauterine fetus
Preeclampsia
Intrauterine oxygen deprivation of the fetus
Infectious complication after
Stillbirth
Weakness of labor
Hypogalactia

One of the components of blood is hemoglobin, which enriches it with oxygen and nutrients necessary for the developing intrauterine fetus. With iron deficiency in the mother's body, there is a significant decrease in hemoglobin levels. The consequence of this is insufficient oxygen supply to the embryo.

Nutrients necessary for the normal development and growth of the embryo enter the body in quantities that do not correspond to the norm. In addition to the risk to maternal health this pathology threatens the health of the unborn child. The most common consequences of anemia in pregnant women that can occur in a newborn baby include:

Rapid weight loss
Incomplete development of internal organs and systems
Functional disorders in the respiratory system
Iron-deficiency anemia
Slow motion mental development, inappropriate for age

According to statistics, the development of these pathologies occurs throughout life and during the formation of a child’s body in the early stages. Unfortunately, at birth, the presence of any diseases resulting from anemia during pregnancy is not diagnosed.

In most cases, such children are weakened, allergic reactions occur more often than others, and they are more susceptible to viral infections, pneumonia and enterocolitis.

Constant systematic visits to the doctor during pregnancy and regular testing will allow you to quickly diagnose anemia and prescribe appropriate treatment. Timely therapy will prevent the development of complications and negative impact, both on the health of the child and on the health of the woman.

Features of diagnosing anemia during pregnancy

The insidiousness of this disease lies in the fact that in a mild degree, characteristic pronounced symptoms are not observed. Despite this, the embryo begins to instantly feel all the changes in the mother’s body. This manifests itself in oxygen starvation, the intensity of which increases in parallel with a decrease in the level of hemoglobin in the blood.

Only regular observation by an obstetrician-gynecologist helps to identify anemia before clinical manifestations based on the results of a blood test. The main indicators of such an examination are the level of hemoglobin and hematocrit.

When diagnosing this disease, a blood composition examination is prescribed, which examines the following indicators:

Number of red blood cells
Hemoglobin level
Hypochromasia
Color indicator
Hemoglobin content in one red blood cell
Serum ferritin concentration
Size and shape of red blood cells
Platelet and leukocyte levels
Erythrocyte sedimentation rate
Reticulocyte count

The development of pathology in the early stages of pregnancy is not observed. In most cases, its appearance occurs during the 2-3 trimester. At this time, the fetus is developing rapidly and consumption nutrients in the mother's body increases significantly.

A slight decrease in the level of hemoglobin and red blood cells in the second half of the term is a normal reaction of the body. A significant drop in these indicators poses a threat to the health of the fetus and woman. This necessitates regular testing every seven or fourteen days.

It is worth remembering that grade I anemia can provoke abnormal development of all systems and organs of the body. Therefore, it is very important to diagnose this in time. Mild anemia can be very easily corrected with nutrition and vitamin-mineral supplements.

Basics of drug therapy for mild anemia during pregnancy

Treatment of anemia is prescribed exclusively by the leading gynecologist-obstetrician based on the results of the examination. The therapeutic complex is selected individually for each woman, depending on the general state of health and the timing of pregnancy.

Therapy for this disease can be:

Nutrition correction
Medication
Integrated

Drug treatment is based on taking iron supplements, which do not cause side effects on the fetus. But among the wide selection of such medications, there are some that can harm the health of a pregnant woman.

Depending on the amount of iron content in the drug and additional components, the dosage and duration of taking a particular drug are prescribed. Also, these indicators determine the reaction of the female body to iron-containing medications. The most common medications used to treat mild anemia during pregnancy include:

Ferroceron
Ferroplex
Sorbifer
Conferon
Totema
Ferrocal
Gyno-tardiferon
Maltofel
Tardiferon

The duration of taking the drugs is 6-9 weeks. Since only with prolonged use does normalization of all blood test parameters occur. It is prohibited to interrupt the course of therapy even if there are clear signs of improvement in health; it must be completed in full.

In most cases, the drugs are taken orally and the tablet form of the drug is used for therapy. The content of divalent in the body should not exceed 55 g.

To improve the absorption of iron in the body, it is recommended to take iron-containing medications in combination with ascorbic and folic acids.
Intramuscular administration of the drug is prescribed exclusively in the presence of diseases of the digestive system in acute form or in case of individual intolerance to the components of the drug.

Drug treatment of mild anemia is carried out exclusively under the supervision of a doctor and on an outpatient basis. Only in cases of severe illness, where there is a threat to the life of the child and mother, can a pregnant woman be hospitalized. In such cases, blood transfusion is performed.

At any stage of the disease, self-medication is strictly prohibited. Correction of the diet in combination with the necessary medications and regular monitoring general analysis blood will avoid complications and hospitalization of a pregnant woman.

Dietary nutrition as a component of complex treatment of the disease

A well-formulated diet plays a significant role in the treatment of anemia. If detected in a timely manner, mild anemia can be corrected solely by preparing the correct diet. In other degrees of the disease, diet is a mandatory component of the complex therapy of this disease.

A feature of the therapeutic diet of a pregnant woman is the presence or increase in iron-containing foods. These include:

Black caviar
Seafood
Meat products
Boiled
Vegetables
Fruits
Fermented milk products
By-products
Nuts
Dark

When treating anemia, it is recommended to exclude legumes, tea, spinach, sorrel, margarine, processed foods, foods high in complex carbohydrates, as well as fatty and fried foods from a pregnant woman’s diet. All products that contain food colorings, flavorings and preservatives.

Nutrition for this pathological process should be as beneficial as possible and contain required amount iron, all components of nutrients and vitamins. There is a recommended list of vitamins that promote better absorption of iron and stimulate the process of hematopoiesis: C, cobalamin, Vitamin B9 and pyridoxine.

If it is not possible to create a correct balanced diet on your own, it is recommended not to neglect this point and seek help from a nutritionist and leading gynecologist.

When watching the video you will learn about anemia.

Paying close attention to your health and taking preventive measures will help you avoid the possibility of developing any degree of anemia during pregnancy. Regular monitoring of a general blood test, a balanced diet, timely treatment of infectious and chronic diseases and preventive administration of iron-containing drugs will minimize the possibility of development during pregnancy.

Anemia or anemia is a syndrome that is often found in women. And pregnant women are most vulnerable to it. After all, during pregnancy, a woman’s body must supply blood and all the substances in it not only to itself, but also to the unborn baby.

What is anemia?

Anemia in medicine is usually called a syndrome in which there is too little hemoglobin in the body, the main blood protein that carries oxygen. This condition can be caused by a lack of red blood cells containing hemoglobin, but most often the cause of anemia in pregnant women is a lack of iron, without which hemoglobin cannot carry out its function.

Anemia and pregnancy

Unfortunately, in practice it turns out that anemia and are two inseparable friends. About a third of women in our country suffer from anemia during pregnancy. And in most cases, the cause of anemia during pregnancy is iron deficiency. The syndrome does not begin to appear immediately after the start of pregnancy, but only in the second and third trimester. And the closer the moment of birth, the more the state of hemoglobin deficiency will worsen.

Why is this happening? First, you need to remember that the female body contains relatively little iron. This is due, first of all, to the fact that women lose a lot of blood, and with it, iron, during menstruation. In the first trimester of pregnancy, a woman does not have periods, and the size of the fetus is still small, so anemia is observed less frequently. And then iron consumption increases. A sharp jump in iron consumption is observed at 16-20 weeks of pregnancy, which is associated with the beginning of the process of hematopoiesis in the embryo. Part of the iron goes to building the fetal body. In addition, the expectant mother’s body’s need for oxygen increases, and, consequently, the need for iron also increases.

In total, a woman needs 1.2 g of iron during pregnancy (with a total amount of iron in the body of 3 g). Average daily requirement women in iron outside pregnancy is 2 mg, and during pregnancy – 4 mg. If the difference is not made up, then the woman’s body will first use iron from reserves in the liver (if any) to create hemoglobin, and then hemoglobin will not be formed at all.

Factors contributing to the development of anemia during pregnancy:

a short break between previous births;
undernutrition or unbalanced diet before pregnancy;
age over 35 years;
age under 18 years;
and other diseases of the gastrointestinal tract and liver;
early manifestation of gestosis, which disrupts a woman’s usual diet;
long (more than 5 days) menstruation in a woman shortly before pregnancy;
chronic infections, primarily hepatitis;
helminthic infestations.

Anemia during pregnancy can be not only iron deficiency. There are also other types of anemia:

hemolytic (accelerated destruction of red blood cells),
aplastic (impaired blood cell synthesis),
caused by a deficiency of vitamin B12 and folic acid.

Therefore, if there are signs of anemia during pregnancy, you should not self-medicate by swallowing packs of iron supplements. In the absence of iron deficiency, this method of treatment can only harm, not only the mother herself, but also her unborn child. It is better to consult a doctor so that he can make an accurate diagnosis.

Gestational anemia during pregnancy

The cause of the gestational form of the disease is pregnancy itself. Sometimes carrying a child simply worsens a woman's pre-existing anemia. This type of disease can no longer be considered gestational.

Factors contributing to gestational anemia:

multiple births,
wrong diet,
gastrointestinal diseases.

Symptoms and signs

Symptoms of anemia during pregnancy are divided into those caused by tissue hypoxia and those caused by a lack of iron in various organs and tissues.

The following manifestations are associated with hypoxia:

weakness;
fatigue;
drowsiness or insomnia;
headache;
decreased memory and concentration;
pallor;
nervousness, irritability.

Signs of iron deficiency in tissues:

brittleness of nails and hair;
dryness and flaking of the skin;
cracks in the skin;
angular stomatitis;
changes in taste and smell;
inflammation of the mucous membranes;
weakened immunity;
liver dysfunction.

Why is this dangerous?

Harm from negative consequences Anemia should not be underestimated. This is especially true for expectant mothers, who must be aware of the dangers of anemia during pregnancy. After all, the health of her unborn baby depends on the health of the mother. Anemia during pregnancy leads to hypoxia of fetal tissues and, first of all, the brain, and insufficient development of its organs. Other consequences of the disease:

gestosis,
bleeding from the uterus,
spontaneous abortion,
premature placental abruption,
premature birth,
stillbirth.

In anemic women, due to muscle insufficiency, childbirth is more difficult. The consequence of this can even be death due to excessive bleeding.

But even if the birth goes smoothly and the baby is born, the problems will not end there. The child may have various diseases, and his mother may not have breast milk.

Babies born from anemic mothers often:

have reduced weight;
have insufficient development of organs and tissues;
have respiratory problems;
are lagging behind in mental and physical development;
suffer from iron deficiency and the anemia caused by it;
have weakened immunity;
more susceptible to allergic reactions.

Degrees of anemia in pregnant women

The degrees of anemia are usually differentiated using the level of hemoglobin in the blood. This parameter is easily determined by a biochemical blood test.

In any case, even the healthiest and most well-nourished woman will have reduced hemoglobin during pregnancy. This is due to the fact that the volume of circulating blood in a pregnant woman’s body increases. There is nothing to be done about this, and this phenomenon is recognized as a physiological norm. Therefore, the lower limit of normal hemoglobin for pregnant women is slightly reduced compared to the lower limit of normal for non-pregnant women.

Iron deficiency anemia is preceded by a syndrome such as sideropenia. In this condition, abnormally low hemoglobin values are not yet observed, but serum iron and ferritin levels are reduced, indicating depletion of iron stores in the body.

Mild anemia

A mild degree of the disease is observed when the hemoglobin level is 90-100(110) g/l. In many women, mild anemia does not show any symptoms or manifests itself as slight pallor or excessive fatigue. Many women do not notice these symptoms, associating them with a deterioration in health, nerves, etc., which is natural for pregnancy. However, already with initial stage illness, the fetus may develop hypoxia. It is important to begin treating anemia at this stage so that it does not negatively affect the child’s condition and does not develop into more severe forms that threaten his life.

Moderate to severe anemia

When the disease enters the middle stage, it becomes impossible to ignore its manifestations. Signs of anemia during mid-stage pregnancy include:

deterioration of the skin condition (dryness and flaking, cracking),
deterioration of hair condition (dryness, brittleness, loss),
sleep disorders,
tachycardia,
attacks of causeless weakness,
episodic fainting.

With anemia, heart failure can also develop. Sometimes a woman may develop strange eating habits. A woman may experience an indomitable desire to eat chalk, clay, or raw minced meat.

Treatment for anemia, if it has not been carried out up to this point, must be started immediately so that the patient’s condition does not become severe, pregnancy is not terminated prematurely, and the woman does not have to be hospitalized.

Diagnosis of anemia

Diagnostics allows us to determine not only the type of anemia, but also its stage. Blood tests (general and biochemical) help diagnose anemia during pregnancy. The doctor is particularly interested in the following parameters:

hemoglobin level;
hematocrit;
relative and absolute number of main blood cells: erythrocytes, leukocytes, platelets;
hemoglobin content in one red blood cell;
serum iron level;
ferritin level;
reticulocyte count;
blood color index;
size and shape of red blood cells.

If a decrease in hemoglobin levels is detected, a woman needs to have blood tests every 1-2 weeks.

Treatment of anemia

The treatment method depends on the etiology of anemia. With iron deficiency anemia in the initial stage, it is necessary to reconsider the woman’s diet. If there are few foods containing iron in it, then this situation needs to be corrected. A lot of iron is found in meat products (beef, lamb, chicken, turkey), a little less - in fish, eggs, nuts, buckwheat. Of course, not all iron is absorbed. The degree of absorption of iron from meat, for example, is only one fourth.

Beef liver, which nutritionists usually recommend for anemia caused by iron deficiency, should not be consumed during pregnancy due to the high content of vitamin A in this product, which can have a toxic effect on the developing fetus.

There is a lot of iron in fruits and vegetables - plums, pomegranates, spinach, apples. However, iron is absorbed from plant products 3-5 times worse than from meat products, and in the absence of vitamin C in the diet, it is not absorbed at all. It is true that plant foods contain an abundance of vitamin C. However, it should be remembered that it is destroyed during heat treatment. Therefore, a woman can only get iron from fresh vegetables, and not from boiled or stewed ones.

It is also worth remembering that animal fats, tea, foods rich in calcium, and soy slow down the absorption of iron. However, it is unwise to completely abandon foods containing calcium during pregnancy, because it is also required in large quantities to build the fetus’s body.

If diet fails to increase hemoglobin, or the disease is in the middle stage, then they are prescribed. Iron is absorbed from them much more efficiently than from food. There are divalent and trivalent drugs. Bivalent iron is better absorbed, but trivalent drugs have fewer side effects.

Considering the possibility of iron overdose when taking iron-containing drugs, parameters such as the type of drug, dose and course duration should be selected by a doctor. In addition, iron supplements are contraindicated in certain blood diseases.

Many iron preparations contain vitamins and biological active substances that are useful for pregnant women, such as folic acid and cyanocobalamin.

If a pregnant woman for some reason (diseases of the gastrointestinal tract, drug intolerance) cannot take iron supplements orally, then an injection course is prescribed.

Prevention of anemia

If a lack of hemoglobin is not detected in a pregnant woman, this does not mean that the expectant mother is insured against this condition and its consequences. Women should be especially concerned about:

suffered from anemia in a previous pregnancy,
under 18 years old,
over 35 years old,
having multiple pregnancy,
following a vegetarian diet,
suffering from chronic diseases.

The main method of prevention is proper diet. The diet of pregnant women should include basic foods - meat, fish, eggs, fresh vegetables and fruits, nuts, and dairy products. Of course, during pregnancy you should not forget about the need to regularly take blood tests.

A pregnant woman often experiences the condition. During pregnancy, the need for iron increases. It is necessary for the placenta and fetus to grow and develop properly. The amount of iron is often on the borderline of normal and can lead to the subsequent development of deficiency.

Consequences of anemia in pregnant women, its danger to the unborn child

Anemia is a disease characterized by a low level of iron-containing protein hemoglobin in the blood. A decrease in the amount of this protein leads to hypoxia, which impairs the health of the growing fetus and its mother.

The consequences of such a state are always negative. Especially for the unborn child. Persistent anemia can lead to:

to oxygen starvation of the fetus (this inhibits its development and provokes various pathologies);
to toxicosis, which is very dangerous in the second half of pregnancy (it poses a real threat to the life and health of the fetus and its mother);
in the future (after birth), to low hemoglobin in the baby;
to many obstetric difficulties during childbirth;
to placental abruption;
to premature rupture of water and childbirth;
to severe bleeding.

The worst thing that can happen is a miscarriage or stillbirth. It is very important to take this deviation seriously and follow all the doctor’s recommendations.

Hemoglobin norms at different stages of pregnancy

Iron-containing protein transports oxygen to tissues. It is part of red blood cells. To fully supply the body with oxygen, a certain number of such cells is necessary.

Normal hemoglobin levels in a pregnant woman range from 110-140 g/l. They change with increasing gestational age:

in the first trimester (1-12 weeks) the normal range is 110-160 g/l;
in the second trimester (13-26 weeks) – from 108-144 g/l;
in the third trimester (27-40 weeks) - from 100-140 g/l.

When the hemoglobin level drops to the lower limits, this indicates the onset of the development of IDA.

Causes of anemia

A slight decrease in iron levels compared to pre-pregnancy levels is quite normal. Blood volume increases faster than the number of red blood cells. This condition is called hydremia and is not considered dangerous.

Anemia is not an independent disease and occurs in various diseases. In pregnant women it develops according to various reasons, the main ones being:

flaw essential microelements before pregnancy;
development of dysbacteriosis, especially in erased form;
liver diseases in which iron transport is disrupted;
psychological state: stress, nervousness, which can cause metabolic failures;
insufficient dietary iron intake;
multiple pregnancy;
rapid increase in blood volume (plasma);
transfer of part of the iron to the placental tissue and for fetal development;
large blood loss during childbirth.

Additional factors that contribute to the development of IDA are the harmful effects of toxic substances (due to poor environment, work).

The risk of anemia increases due to the presence of chronic diseases, especially disorders in the immune and endocrine systems.

Stages of anemia development

On initial period development of iron deficiency, the body mobilizes using its reserves. The absorption of the microelement in the intestine improves, compensating for the deficiency for a while. Over time, the latent form of deficiency passes into the initial stage of anemia.

There are three main stages of IDA, which are classified according to severity based on the quantitative deficiency of iron-containing protein and hemoglobin level.

Data corresponding to each stage of anemia are presented in the table:

It is very important to know the level of hemoglobin, especially in the second half of pregnancy, when the fetus quickly gains weight and its oxygen needs increase.

Clinical symptoms of IDA directly reflect the severity and rate of development. At the initial stage, with a mild stage, the signs may be almost invisible.

Due to activation internal systems and redistribution of iron reserves, the need for oxygen is ensured for some time.

When more than acute stage iron deficiency symptoms appear. They increase with a further drop in the level of red blood cells.

In this condition, a woman may have:

increased heart rate;
feeling of squeezing in the sternum;
weakness throughout the body and increased fatigue;
insomnia;
feeling of a lump in the throat making it difficult to swallow;
dizziness and tinnitus;
dyspnea;
fainting;
failures taste buds(perverted taste);
decreased appetite and indigestion;
frequent urination.

A woman can observe these symptoms on her own. This is a reason to consult a doctor who will prescribe the necessary examinations.

Upon external examination, the following signs become noticeable:

muscle weakness throughout the body;
dry skin, flaking;
slight yellowness and pallor of the skin (in the nasolabial area);
fragility of nails;
cracks in the corners of the mouth (jams);
the appearance of angular stomatitis;
fragility and dryness of hair, increased hair loss;
itching and burning sensation in the vagina.

These signs appear due to tissue hypoxia, which directly indicates the presence of anemia.

Diagnosis of IDA during pregnancy, necessary examinations and tests

Anemia can be suspected by a woman's physical examination and general history. The appearance of signs of low hemoglobin is an indication for examination. The final diagnosis of IDA is made upon receipt of test results. Based on their indicators, the stage of anemia is determined.

donate blood in the morning, on an empty stomach (except in emergency cases);
the day before the test, do not eat fatty or fried foods;
have a good rest before the analysis (a full night's sleep is important);
Tell the laboratory technician if you are taking any medications.

The presence of IDA is indicated by blood examination data:

An increase in ESR, an increase in platelets and reticulocytes is also possible. Leukocytes will correspond to the lower limit of normal.

Additional diagnostic procedures include:

study of the biochemical composition of blood;
general urine analysis;
Ultrasound of the kidneys, thyroid gland and abdominal cavity (if a severe form is suspected);
taking a puncture and performing a biopsy (according to indications).

They may schedule consultations with specialists: nephrologist, gastroenterologist, phthisiatrician, endocrinologist, hematologist.

Treatment methods for iron deficiency anemia in pregnant women

The goal of therapy is to replenish the amount of iron and trace elements. It is necessary to carry out complex therapy that will eliminate the causes of iron deficiency. Treatment consists of several stages:

stopping the progression of the deficiency;
increasing iron reserves in the body;
maintaining normal levels throughout pregnancy.

If IDA is diagnosed, self-treatment is unacceptable. You should especially not take medications uncontrollably. All methods of therapy to increase hemoglobin levels should be prescribed by the doctor managing the pregnancy. This concerns traditional methods and dietary changes.

Treatment with drugs

For anemia, iron supplements are used. The duration of use and dosage are determined by the doctor, based on the condition of the woman and the fetus. The stages of development of IDA are also taken into account.

Medicines are prescribed in the form of tablets, pills or capsules. Use vitamin B12.

Maltofer. Chewable strips based on ferric iron.
Ferroplex. The composition of the medicine includes ferrous iron salts and ascorbic acid.
Aktiferin. A popular representative of ferrous iron. Produced in the form of tablets, syrup and capsules.
Gyno-Tardiferon. French preparation consisting of ferrous iron and mucoproteosis. This is a substance that provides a slow release of trace elements.
Ferlatum. Ferric iron solution.

The daily norm for the treatment of mild anemia is 60-100 mg of iron. In case of severe deficiency - 100-120 mg (in the form of iron sulfate).

To improve the absorption of the microelement into the blood, it is recommended to take ascorbic acid. You can take the tablets with juice containing vitamin C.

Many experts prescribe folic acid in combination with iron supplements.

A blood test will determine normal indicators only after 5-7 weeks.

The composition of the medicines includes B vitamins, folic acid, vitamin C.

When there is iron intolerance when taken orally, impaired absorption or severe anemia, medications are administered enterally (injections intramuscularly, intravenously, into the abdominal cavity). For injections, ferric iron preparations are used. The dose is calculated using a special formula.

The best form of taking iron supplements is considered to be oral. She has much less side effects than injections.

Folk remedies for the treatment of IDA during pregnancy

Many folk recipes can be used both as maintenance therapy and for the prevention of iron deficiency anemia. Before using any traditional methods, you should consult a doctor to exclude contraindications and possible allergies to the components of the remedy.

With insufficient hemoglobin levels ethnoscience recommends:

Eat 100 g of boiled beets on an empty stomach.
Drink birch sap (1 tbsp. 2 rubles per day).
Take 2 tbsp. l. squeezed beet juice. It should stand in the cold for a couple of hours.
Drink warm cabbage juice 1/3 tbsp. half an hour before meals.
Take an infusion of a mixture of rose hips and chokeberry. Calculation – 2 tbsp. spoons for 1 tbsp. boiling water You can infuse it in a thermos. Drink 1/2 glass 2-3 times a day.
Dilute 1 tbsp. viburnum juice with a liter of water, add honey to taste. Take all day instead of water.
Brew with green tea and drink dried strawberry, viburnum and sea buckthorn leaves.

There are many recipes for increasing hemoglobin. They are different and need to be selected individually, taking into account the composition and possible reactions of the body.

Nutrition to increase hemoglobin levels

Special nutrition is an important component in the treatment of iron deficiency anemia. Increasing the intake of iron from food at the initial stage of anemia can normalize hemoglobin without taking medications.

Attention! Products that increase the manifestations of toxicosis and cause an allergic reaction are excluded from the pregnant woman’s menu.

The treatment diet includes foods high in iron and other trace elements (manganese, selenium, cobalt, copper). The diet is enriched with vitamins B and C.

The daily menu includes the following products:

cereal porridge (buckwheat, oatmeal, millet);
beef liver and brains;
cottage cheese;
lean beef;
sea fish, seafood;
green vegetables and salads (peas, cabbage, spinach, parsley);
legumes (beans, soybeans, peas);
potatoes, zucchini, pumpkin;
garlic and onion;
fresh fruits (apricot, melon, gooseberry, black grapes, pear).

Freshly squeezed fruit and vegetable juices made from several types of raw materials are very useful. It is recommended to drink an infusion of rose hips and sea buckthorn.

Red beets and pomegranate contain a lot of iron. It is recommended to drink beetroot and pomegranate juices. It is necessary to take into account the properties of these products: they have a strengthening effect, and beets have a laxative effect.

Very high level iron in animal liver (pork, veal). They are in first place in terms of the level of assimilation of this element.

Prevention of iron deficiency anemia in pregnant women

The primary measures to prevent anemia can be considered a timely determination of the level of hemoglobin in the body and identification possible reasons the appearance of anemia at an early stage.

There is a group at increased risk of developing IDA. It includes:

women with multiple pregnancies;
pregnant women with chronic diseases;
women who have given birth frequently (if the period between pregnancies is short);
blood donors;
women from low-income families (poor nutrition is expected).

In such cases, preventive therapy is carried out throughout the entire period of pregnancy, accompanied by regular monitoring of hemoglobin levels. Iron intake is continued after childbirth to replenish iron reserves.

According to the recommendations of specialists preventive measures consist of taking iron supplements and folic acid. The effective daily dose is 60 mg of iron (ferrous) and 250 mg of folic acid. It is better to take combination drugs containing both components.

A good remedy for prevention would be, which is used to treat anemia, and taking vitamin drinks.

Hemoglobin levels during pregnancy should always be monitored by a doctor.

Video about anemia during pregnancy

IDA in pregnant women is explained in an accessible and popular way in this video:

The likelihood of developing iron deficiency anemia during pregnancy should not be underestimated. Prevention not started on time or curative therapy can lead to irreversible consequences, because both the expectant mother and the unborn baby are in danger.

During pregnancy, doctors closely monitor the amount of hemoglobin in a woman’s blood. Low levels indicate the presence of anemia, which, although common, is undesirable. Find out what are the causes of this disease, what are its symptoms and treatment methods from our article.

The following factors can be considered as prerequisites for the appearance of iron deficiency in the blood:

Poor nutrition of a pregnant woman, insufficient amount of vitamins in the diet. This may be a consequence of diets, irrationally designed menus, and poor living conditions.
Diseases of the digestive tract can lead to anemia, especially if they are accompanied by bleeding. Along with blood loss, the human body is deprived of many useful elements. Diseases of the stomach and intestines also reduce the absorption of nutrients from food.
Changes in the hormonal system can affect the production of red blood cells, which also leads to a decrease in hemoglobin.
Another cause of anemia is considered to be a decrease in immunity, which is a natural phenomenon after conception.
Lack of protein, vitamin B12 and folic acid in the body also leads to iron deficiency in the blood.
Any heavy bleeding causes anemia.

Some women are more susceptible to developing the disease than others. Iron anemia during pregnancy most often develops in the following individuals:

vegetarians;
women who have previously had several pregnancies;
pregnant teenagers;
previously suffered from dysentery, pyelonephritis, hepatitis;
those who suffered from heavy bleeding during menstruation;
women with polyhydramnios;
pregnant women carrying twins;
women with chronic rheumatism, tonsillitis, enterocolitis, gastritis, duodenitis;
those suffering from heart defects;
those who had anemia in previous pregnancies;
pregnant women during lactation;
patients with diabetes mellitus;
women suffering from early toxicosis, threat of miscarriage, viral diseases during pregnancy.

Types of anemia

Iron deficiency anemia is usually classified according to severity. Depending on this indicator, three types of disease are distinguished;

1st degree anemia during pregnancy is considered the mildest manifestation of the disease, the hemoglobin level in this case is 110-91 g/l;
Grade 2 is diagnosed when the hemoglobin level is 90-71 g/l;
Anemia of the 3rd degree is considered a serious disease, the hemoglobin level is less than 70 g/l.

Mild anemia during pregnancy occurs in a fairly large number of women; this phenomenon does not cause any discomfort and the initial degree of iron deficiency can only be detected using a blood test. If you do not pay attention to the lack of hemoglobin in time, a mild degree can develop into a more severe one.

The second degree of anemia during pregnancy is already felt physically. A woman may experience some weakness, fatigue, and slight dizziness. Lack of iron affects the condition of the skin. This disease negatively affects the child, as he does not receive enough oxygen through the blood.

Severe anemia is treated with medication, including inpatient conditions and under the supervision of a doctor. This condition is very dangerous for the development and life of the child, as well as for the health of his mother.

Symptoms of anemia during pregnancy

At the initial stage, a deficiency of hemoglobin in the blood does not manifest itself with any noticeable symptoms, and doctors determine the presence of anemia using blood tests. But in more advanced stages the disease makes itself felt with the following phenomena:

weakness in the body, drowsiness, fatigue;
fainting states;
increased heart rate;
nervousness, irritability;
decreased concentration;
dizziness;
pain in the heart;
disturbances in the functioning of the digestive system;
decreased appetite.

Anemia often affects the appearance of a pregnant woman, which is expressed in pale skin, drying and flaking of the skin, brittle nails, hair loss, and the appearance of cracks on the lips.

The presence of anemia can be diagnosed both by the symptoms described above and by a blood test for hemoglobin. Such tests are carried out regularly during pregnancy to monitor the health of the expectant mother. Very often, anemia accompanies the third trimester of pregnancy, but in some patients the disease manifests itself much earlier. Blood sampling for analysis is carried out once a month for early stages and once every 2 weeks in later stages of pregnancy.

What does iron deficiency anemia mean for a mother and her child?

Anemia during pregnancy can have unpleasant consequences. Lack of iron can cause late toxicosis; with anemia, the amount in the blood decreases. necessary elements: nickel, cobalt, manganese, zinc. Hemoglobin deficiency reduces a woman’s immunity and worsens the course of redox processes. About a third of women with anemia suffer from early toxicosis; with the disease of the second and third degrees, the risk of developing preeclampsia is 48%. Almost half of pregnant women with anemia are at risk of miscarriage, and at least 40% are susceptible to placental abruption. Approximately the same number of patients suffer from low blood pressure, and a third of pregnant women experience fetoplacental insufficiency. In addition to the above threats, the unpleasant consequences of iron deficiency anemia can be: weak labor, premature birth, severe postpartum hemorrhage.

Anemia during pregnancy is fraught with consequences for the child. With severe oxygen starvation, fetal development slows down or stops altogether; after birth, the baby may experience various diseases and defects. Even when the expectant mother suffers from mild anemia, her baby is often born with low level hemoglobin in the blood and in the first year of life his body simply cannot form the required amount of iron. The consequences of this phenomenon can be frequent colds, acute respiratory viral infections, pneumonia, allergic diseases, enterocolitis and other diseases.

Treatment of anemia during pregnancy

Anemia at an early stage can be cured with the help of a properly selected diet and vitamin complexes. For more complex conditions, drug therapy is also added to adherence to a certain diet. Let's look at the methods of treating iron deficiency anemia in more detail.

Principles of nutrition for iron deficiency

Among the foods richest in iron, red meat ranks first. It is from meat that the human body can absorb at least 30-35% of the necessary substance. Iron is also found in other foods, but the percentage of its absorption is somewhat lower and does not exceed 17%. To prevent the development of anemia or cure this disease at an early stage, a pregnant woman is recommended to include the following foods in her regular diet:

chicken or quail eggs, the most useful part of which is the yolk;
pork, beef, veal or chicken liver;
veal;
turkey meat;
chicken or pork hearts;
spinach;
apricots;
almond.

The ratio of nutrients consumed directly affects the level of iron in the body. On initial stages While pregnant, a woman should consume at least 75 g of protein, 85 g of fat and 350 g of carbohydrates daily. The calorie content of food should be approximately 2700-2800 kcal per day. Starting from the middle of the second trimester, the norms of nutritional components can be increased by consuming approximately 130 g of protein, 100 g of fat and 420 g of carbohydrates per day. The calorie content of food at this stage should be up to 3200 kcal per day.

All useful material can be extracted from foods that are richest in them. For example, good sources of protein are: beef, tongue, heart and liver, chicken and quail eggs, milk. As sources of lipids the best option considered cheese, sour cream, cottage cheese, cream. A variety of grains and cereals, beans, as well as fruits, vegetables, dried fruits, berries and nuts are rich in carbohydrates. A woman’s diet must include fresh herbs and natural honey, unless she is allergic to it.

Drug treatment of iron deficiency anemia

In case of anemia of the second and third degree, a properly formulated diet is not enough; iron deficiency will have to be replenished medicines. Fortunately, today there are many iron-containing preparations, many of which can be safely used during pregnancy and the lactation period. Effect of drug treatment not fast and visible results appear in 2-3 weeks of such therapy. By this time in the blood expectant mother Hemoglobin begins to increase, and normal red blood cell production is established only after 5-8 weeks of treatment.

It is advisable to take iron supplements during meals, since this is when the effect of therapy will be faster. But you need to take into account that certain foods and some medications can slow down the absorption process. Iron-containing medications are usually prescribed in combination with ascorbic acid. The daily dose of iron for most pregnant women should not exceed 55 mg; an overdose of the drug can lead to disturbances in the functioning of the digestive tract.

Essential vitamins for iron deficiency

The development of anemia during pregnancy is affected not only by iron deficiency, but also by deficiency of other vitamins. That is why, from the first weeks after conception, expectant mothers are recommended to use various vitamin complexes for pregnant women. Let's take a closer look at which vitamins are especially important for a woman’s health and the normal development of her child:

Tocopherol or vitamin E is considered an excellent antioxidant. It participates in the formation of the placenta, is responsible for the blood supply to the uterus and ovaries, and helps the production of progesterone, the main hormone of pregnancy. The following foods are rich in vitamin E: parsley and spinach, tomatoes, rose hips, lettuce, vegetable oils, especially olive, corn and sunflower.
Ascorbic acid, known to us as vitamin C, has antioxidant properties and is directly involved in the process of iron absorption by the human body. Among other things, this vitamin is responsible for the production of interferon, which means that the immunity of the expectant mother largely depends on the amount of ascorbic acid consumed. You can get vitamin C from lemons and other citrus fruits, from rose hips, raspberries, black currants, cabbage, bell pepper and baked potatoes.
Vitamin B9 or folic acid takes part in the hematopoietic process. The lack of this substance leads to a deficiency of red blood cells and contributes to the development of anemia. Folic acid should be consumed at all stages of pregnancy, and it is advisable to start taking the vitamin while planning conception. Among foods rich folic acid, you can highlight nuts, honey, green vegetables, liver, yeast.
Vitamin B6 accelerates metabolic processes, is responsible for the absorption of proteins, and is involved in the production of hemoglobin and red blood cells. To compensate for the deficiency of this substance and to prevent the development of iron deficiency anemia, it is recommended to introduce legumes, red meat, fish, and nuts into your diet.
Vitamin B12 takes part in the production of red blood cells and affects the formation of DNA and RNA cells. The lack of this vitamin is one of the factors in the development of iron deficiency anemia. The main sources of this substance are products of animal origin: fish, eggs, meat, cheese, and brewer's yeast.

Anemia during pregnancy. Video

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