DEFINITION: The world health organisation (WHO)
index for anaemia in pregnance is when the haemoglobin level in the
peripheral blood is Hg/dl or less. However, from practical experience in
tropical obstetrics it is generally accepted that anaemia in pregnancy
Exist when the Haemoglobin level is less than in loglde or the packed
cell volume less than 30%
Anaemia in pregnancy presents a
world-wide problem but it is uncommon in developed world. the importance
of anaemia in pregnancy in the tropics lies firstly in its greatly
increased incidence, and secondly in the seventy of the anaemia with
which the patients commonly present for treatment. Both combine to make
this complication of pregnancy a major cause of matanal and fetal death
in the tropics. A third important problem posed by anaemia in the
tropics is polymorphism. In almost all cales, the anaemia is caused by
multiple factors whole individual importance varies from area to area.
This makes rational prophylaxis and treatment much more difficult.
Complicaion of pregnancy in the for at belt of West Africa, between
January and April 1955. it was directly responsible for more than 20% of
all matanal deaths in patients under the car of the Department of
obstetrics, university college Hospital, Ibadan. It also contributed to
many other deaths from Antepartum haemorrhage, postpartum haemorrhage
and puerperal sepsis. In Nigeria it is a frequent complication, its
incidence is high and its severity is staggering. The clinical feathers
of anaemia in pregnancy in Nigeira are different from those encountered
in temperate countries not only because of the severity of symptoms but
also because of the concomitant autuminosis such as marked glossitis,
Angular stomatitis and associated gross hepatomegly. Agbola A. (1991)
Anaemia in pregnancy could be
mild, moderate or severe based on the haemoglobin level in the
peripheral blood as well as the clinical manifestations and the
management would differ for each.
TYPES OF ANAEMIA HB LEVEL
Mild Anaemia in pregnancy 9-Hg/dl
Moderate Anaemia in pregnancy 7-9g/dl
Severe Anaemia in pregnancy 7g/dl
For haemoglobin and Red blood
cell synthesis, iron, folate, vitamin Biz and Vitamin c, trace elements
like cobate and copper, and proteins are required. Erythroporetin
produced by the renal parenchyma stimulates the bone marrow to increase
erthropesis which is one of the noticeable physiological changes in
pregnancy. Barnes, F.C (1994).
In the non-pregnant female, the total
body is about 3.5-kg. 2/3 of this is Haemoglobin another ¼ is in the
body stores and the remaining is in the tissue and plasma. Iron is
stored in the liver and spleen as femitin and in bone marrows
haemosiderin. Iron in the serum is bound to transfer in, a B1 – globulin
and transfers is only 1/3 saturated with iron. A good diet provides
about 10-15mg of iron per a day and only 10% of this is absorbed. Iron
is mainly absorbed in the duedenuim and to some extent in the upper
jejunum. The absorption is influenced by dietary phosphates, phytaces,
ascorbic acid, sugars especially frutole, Hell in the stomach and
gastric factors namely factors I, II and II, iron is lost in the bile,
urine, fences, sweat and during menstruation. About 1-2mg of iron is
In normal pregnancy, iron demand is increased many folds.
The fetus need about 350mg, the placenta about 100mg: the increased
material haemoglobin mass about 350mg and that from lactation about
150mg. In adding the pregnant women still excretes iron but on the
credit side about 225mg of iron is available as a result of the
amenorrhea of pregnancy is about 15%. The increased iron requirement is
not uniformly spread over the period of pregnancy but as pregnancy
advances from 28 weeks onwards, the increased demand is noticed as a
resultant drop in PCV or HB concentration it no iron supplementation has
been given Abidu, O, Sofola (1990).
In the absence of effective treatment, anaemia develops progressively as the pregnancy advances.
The following complications may occurs;
I. CONGESTIVE CARDIA FAILURE: This is the main effect of anaemia muscle oxygen lacse. The most dangerous period is during the first 12 hours after delivery.
SHOCK: Severely anaemic women readity go into shock as a result of very
small amount of blood loss and motality in such patients.
This disease cannot be cured, but can
be managed for some extent. Air travel during pregnancy should be
avoided, especially in unpressurised air crafts sinle the resultant
anorexic may cause splenic or other vital organ infection of anaemic
pregnant women in our environment should be examined for worms and ova
of hookworm. However infestation of hookworm can be prevented by good
food and personal hygiene and also protecting the slein from penetration
for the worms by wearing fast wears.
Blood transfusion is given with
caution in cases where the anaemia is severe, that is HB less than
5g/dl or PCV less than 5% or in cases where moderate anemia co-existing
with seplis or Haemorrhage is discovered late after 36 weeks or in
labour or immediate pos-partum
AIMS AND OBJECTIVES
The project work is aimed at the following:
1. To determine the haemoglobin level (HB) packed cell volume (PCV) and erythrocyte sedimentation rate (ESR) of pregnant women.
To determine the significance of age, educational level, occupation,
severity and gestational age to the occurance of anaemia in pregnancy.
STATEMENT OF PROBLEMS
1. Most pregnant women in
the rural area prefers to go to farm rather than going to atenantal, so
as a result can become anemic because they are not enlightened about
their nutritional intake.
2. Because the foetus in the feeds more
during 3rd trimester, so a pregnant women can appear healthy while she
is anaemic, the only way to dectate such case is during laboratory test
(HB, PCV, ESR) etc.
LIMITATION / SCOPE
2. The use of HB level in the body is not the infections.