Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Type of Anaemia in Pregnancy | Clinical Presentation | Important Clinical Signs | Investigations | Management |
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Iron Deficiency Anaemia | Fatigue, weakness, shortness of breath, palpitations, dizziness |
- Pallor (especially conjunctiva)
- Glossitis (smooth, swollen tongue) - Angular stomatitis (cracks at mouth corners) - Brittle nails - Pica (craving for non-food items) |
- Full blood count (FBC) showing low haemoglobin, low mean corpuscular volume (MCV)
- Low serum ferritin, low serum iron, increased total iron-binding capacity (TIBC) |
- Oral iron supplements (ferrous sulfate)
- Intravenous iron in severe cases - Dietary modifications (iron-rich foods such as red meat, leafy greens) - Vitamin C supplementation to enhance absorption |
Folate Deficiency Anaemia | Fatigue, weakness, difficulty concentrating, irritability |
- Pallor
- Glossitis - Nausea and weight loss - No neurological signs (unlike B12 deficiency) |
- CBC showing low haemoglobin, macrocytosis (high MCV)
- Low serum folate levels |
- Oral folic acid supplementation (400-800 mcg daily)
- Dietary sources (green leafy vegetables, legumes) - Prenatal vitamins with folic acid |
Vitamin B12 Deficiency Anaemia | Fatigue, weakness, shortness of breath, neurological symptoms (numbness, tingling, difficulty walking) |
- Pallor
- Glossitis - Neurological signs: peripheral neuropathy (numbness, tingling), difficulty walking, loss of balance - Jaundice (in severe cases) |
- CBC showing low haemoglobin, macrocytosis (high MCV)
- Low serum B12 levels - Elevated homocysteine and methylmalonic acid levels |
- Vitamin B12 injections (intramuscular)
- Oral B12 supplements (for mild cases) - Dietary modifications (B12-rich foods like meat, eggs, dairy) |
Haemolytic Anaemia (e.g., Sickle Cell Disease) | Fatigue, jaundice, dark urine, pain crises (in sickle cell), shortness of breath |
- Pallor
- Jaundice - Splenomegaly - Dark urine - Sickle cell crises (painful vaso-occlusive episodes) |
- CBC showing low haemoglobin, reticulocytosis
- Peripheral blood smear (sickle cells or schistocytes) - Elevated lactate dehydrogenase (LDH), indirect bilirubin - Haemoglobin electrophoresis (in sickle cell) |
- Management of sickle cell crises (hydration, analgesia, oxygen therapy)
- Blood transfusions (for severe anaemia) - Folic acid supplementation - Prophylactic antibiotics (in sickle cell) and close monitoring during pregnancy |
Anaemia of Chronic Disease | Fatigue, weakness, poor exercise tolerance |
- Pallor
- No specific signs except those related to underlying chronic disease (e.g., autoimmune disease, chronic infections) |
- CBC showing mild to moderate anaemia, normal or low MCV
- Normal or increased ferritin, low serum iron, low TIBC |
- Treat underlying chronic condition
- Iron supplements generally not effective unless coexisting iron deficiency - Erythropoietin (in selected cases) |