Anemia during pregnancy

Anemia is a lack of red blood cells, which can lead to a lack of oxygen-carrying ability, causing unusual tiredness. The deficiency occurs either through the reduced production or an increased loss of red blood cells. These cells are manufactured in the bone marrow and have a life expectancy of approximately four months. To produce red blood cells, the body needs iron, vitamin B12 and folic acid. If there is a lack of one or more of these ingredients, anemia will develop.

Red blood cells are the cells that circulate in the blood plasma (fluid) and give blood its red color. Through its pumping action, the heart propels the blood around the body through the arteries. The red blood cells obtain oxygen in the lungs and carry it to all the body's cells. The cells use the oxygen to fuel the combustion (burning) of sugar and fat, which produces the body's energy. During this process, called oxidation, carbon dioxide is created as a waste product. It binds itself to the red blood cells that have delivered their load of oxygen. The carbon dioxide is then transported via the blood in the veins back to the lungs where it is exchanged for fresh oxygen by breathing.

Causes of anemia during pregnancy

• Women often become anemic during pregnancy because the demand for iron and other vitamins is increased.
• The mother must increase her production of red blood cells and, in addition, the fetus and placenta need their own supply of iron, which can only be obtained from the mother.
• In order to have enough red blood cells for the fetus, the body starts to produce more red blood cells and plasma.
• It has been calculated that the blood volume increases approximately 50 per cent during the pregnancy, although the plasma amount is disproportionately greater.
• This causes a dilution of the blood, making the hemoglobin concentration fall.
• This is a normal process, with the hemoglobin concentration at its lowest between weeks 25 and 30.
• The pregnant woman may need additional iron supplementation, and a blood test called serum ferritin is the best way of monitoring this.

Other causes include:

• A diet low in iron Vegetarians and dieters in particular, should make sure their diet provides them with enough iron
• Lack of folic acid in the diet, or more rarely, a lack of vitamin B12
• Loss of blood due to bleeding from hemorrhoids (piles) or stomach ulcers
• Anemia is more common in women who have pregnancies close together and also in women carrying twins or triplets.

Symptoms of anemia during pregnancy

• If the woman is otherwise healthy, she will rarely have any symptoms of anemia unless her hemoglobin (red pigment) is below 8g/dl.
• The first symptoms will be tiredness and paleness.
• Palpitations – the awareness of the heartbeat, breathlessness and dizziness can occur, though they are unusual.
• If the anemia is severe it may cause chest pain or headaches.

 Avoid anemia during pregnancy

• Be sure to get a varied diet.
• If planning a pregnancy, talk to a doctor or midwife about food and supplements – if possible, before becoming pregnant.
• Good sources of iron are beef, whole meal bread and cereals, eggs, spinach and dried fruit.
• To absorb the maximum amount of iron from the diet, it will help to also eat a diet rich in vitamin C. Raw vegetables, potatoes, lemon, lime and oranges are all good sources of vitamin C.
• Foods rich in folic acid include beans, muesli, broccoli, beef, Brussels sprouts and asparagus.
• A pregnant woman should take notice of her body's signals and consult a doctor if any symptoms occur.
• It is now routine to recommend to women planning a pregnancy to take a folic acid supplement for the first 12 weeks of pregnancy and preferably starting before conception. This reduces the risk of spinal cord defects developing in the fetus.

Possible complications of anemia

• Difficulty in breathing, palpitations and angina
• Severe anemia due to loss of blood after the delivery if this occurs, and then a woman may be advised to have a blood transfusion.

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