Pregnancy is characterized by an increased consumption of all nutrients. Since during this period the woman's body must support not only itself, but also provide building material for the baby. In the intrauterine state, the child grows as never before at a tremendous speed.
Anemia is the most common disease of women during pregnancy. It occurs both independently and as a complication of other diseases. This condition poses a risk to the health of the fetus in the first place, but the mother's body also feels the disadvantage.
What is anemia?
Anemia is a decrease in the level of hemoglobin and / or red blood cells in the peripheral blood.
The normal level of hemoglobin is considered from 120 g / l. Considering that the fetus requires resources from the mother, the amount of hemoglobin in pregnant women will be in the range of 110 g / l.
There are several degrees of severity of anemia:
- A mild degree is characterized by a hemoglobin content within 109-90 g/l ;
- With an average degree, hemoglobin drops to numbers 89-70 g/l ;
- Severe anemia is characterized by a drop in hemoglobin levels below 69 g/l .
The norm of hemoglobin during pregnancy should be considered individually, taking into account the trimester and the presence of concomitant diseases.
Causes of a decrease in hemoglobin in pregnant women
By the third trimester, the volume of circulating blood increases. Thus, dilution occurs, and hemoglobin becomes less in relation to volume. Therefore, by the end of pregnancy, the number of women with anemia increases.
If a woman's hemoglobin level is below normal in the initial stages or fluctuates in the lower normal range, such pregnant women should be observed and preventive treatment should be carried out.
Women who suffer from the following conditions are at risk for anemia:
- Pregnant women with chronic diseases. For example, hepatitis, gastritis, peptic ulcer of the gastrointestinal tract, pyelonephritis, helminthic invasions;
- With a diet with low meat intake, unbalanced nutrition (anarexia, vegetarianism);
- The presence of blood clotting diseases (thrombocytopenia, coagulopathy);
- Women who had a decrease in hemoglobin levels before pregnancy;
- Complicated obstetric history (abortions, miscarriages, bleeding);
- With multiple pregnancy;
- With gestosis of the second half of pregnancy;
- The age of the pregnant woman is up to 18 and after 32 years.
Manifestations of anemia
Anemia can pass without any symptoms, and often the expectant mother writes off minor changes in health as an “interesting” situation. But in more severe cases, the manifestations will be pronounced. Signs of anemia during pregnancy:
- General weakness, including muscle weakness;
- Pale coloration of the skin and mucous membranes;
- Jams in the corners of the lips;
- Changes in the perception of taste and smell (addictions to previously unpleasant odors);
- There may be a rapid heartbeat, chest pain, shortness of breath;
Possible complications of pregnancy with anemia
Complications from the fetus are quite common, especially if a woman suffered from anemia even before conception and did not correct this condition.
Low hemoglobin during early pregnancy can lead to incorrect placement of the placenta. With anemia, underdevelopment, low location or complete blocking of the entrance to the uterus by the placenta occurs. All these changes and conditions can lead to abortion, bleeding, hypoxia (oxygen starvation) and fetal growth retardation.
In childbirth, women with low hemoglobin levels are more likely to suffer from weakness of the birth forces, which subsequently leads to hypotension (muscle relaxation) of the uterus. Hypotension of the uterus is a formidable complication of the postpartum period, which is manifested by bleeding. A newborn from an anemic mother is born with a number of problems.
Low body weight and underdevelopment at birth in a child is due to the fact that in utero the baby received an insufficient amount of nutrients and oxygen.
Children are born with an underdeveloped and unadapted respiratory system, they lag behind their peers in development, both physically and intellectually.
How to diagnose anemia
In addition to all clinical manifestations, a general blood test will help in making a diagnosis. The doctor pays attention to the following indicators:
- The amount of hemoglobin, normal during pregnancy, is 110-150 g / l;
- The level of erythrocytes in anemia is below 3.5 million.
- The color index evaluates the level of hemoglobin in the erythrocyte (0.33-0.4);
- Serum iron is determined in a biochemical blood test. The lower limit of the norm is 10 µmol/l.
In the third trimester of pregnancy, relative anemia can be observed. This means that the amount of hemoglobin remains the same, but the volume of blood has increased due to plasma. In this case, the diagnosis will help to determine the level of serum iron.
How to increase hemoglobin level?
A pregnant woman with a low level of hemoglobin should be observed by a general practitioner. In severe degrees, the absence of improvement from the use of drugs for 1.5 months or the appearance of complications, observation by a hematologist is indicated.
Treatment of even a mild degree of this disease with the help of diet therapy rarely brings positive effects. In any case, the recommended diet should be high in protein and iron. Products that should be included in the diet of a pregnant woman, even for preventive purposes:
- Beef liver contains the most iron and protein;
- Fish and seafood;
- Veal meat, beef;
- Cereals;
- Spinach, lettuce.
Treatment with drugs consists of several stages. The first step is to restore hemoglobin numbers to normal levels. Given the abandoned depot, you need to restore the supply of iron. And subsequently, maintenance therapy is prescribed until the end of pregnancy.
- Pregnant women, regardless of the level of hemoglobin, receive a prophylactic dose of iron and folic acid before the term of delivery;
- If a decrease in hemoglobin is detected, the dose of iron is doubled;
- The drugs are prescribed in tablets and only in especially severe cases, intravenous drugs and blood components are prescribed;
Ascorbic acid improves iron absorption. But during pregnancy, this vitamin should be used with great care and only after 37 weeks. In all other terms, the use of "ascorbic acid" can cause a threat of abortion. Preparations for the treatment of anemia during pregnancy: Ferronat, Ferlatum, Fefol, Ferretab, Totem.
Prevention of anemia
Iron deficiency anemia during pregnancy may not occur if proper prevention is carried out.
A woman should lead a healthy lifestyle, spend more time outdoors. Nutrition should be balanced in all trace elements and basic substances, contain meat and fresh vegetables.
Pregnancy must be planned. If anemia is detected, get treated. It is important that normal blood counts are maintained for several months before conception, in order to replenish the depot. The entire pregnancy will have to take iron supplements in a prophylactic dose.
Iron deficiency anemia - why we need iron
Iron is part of one of the most important proteins - hemoglobin, which is responsible for transporting air through the blood vessels. Despite the fact that the content of iron in humans is relatively low, its deficiency can result in serious problems.
Iron enters the body with food, but it receives only a small part of it. So, for example, a pregnant woman, adhering to a suitable diet, consumes about 15 mg of this substance per day, but the body gets only a small 15% of this mass - only 1-2 mg.
As the pregnancy progresses, so does the body's iron intake. This is due to the need to compensate for the large losses of this trace element - it is spent on the development of the fetus. The peak itself falls on the 4th month of the term, it is at this time that the bone marrow hematopoiesis of the fetus occurs, which causes an increase in the mass of blood in a woman. This is such a difficult process for the body that it lacks even the natural enhancement of iron absorption - up to 4 mg per day, almost twice as much as the norm.
What happens to iron in the body
Iron, as an element necessary for the body, is absorbed during digestion. It occurs in the jejunum and in the duodenum. And this process does not always go smoothly. It all depends on how healthy a person is - all sorts of chronic diseases of the intestines and stomach can significantly complicate the absorption of iron.
In addition, the level of this trace element in the body has a great influence.
Medications taken with food, as well as the product in which we consume iron and the food that gets inside with it, have a significant effect.
The latter factors are actually not as innocent as they seem at first glance. Iron is a complex element and can be found in food in two forms. Depending on the form, the level of its assimilation also changes. So, heme iron, which is part of hemoglobin, loses protein bonds during digestion and is absorbed by the inner lining of the intestine. At the same time non-heme iron that exists outside the protein is absorbed much worse.
Heme iron is also important because it is this type that is found in hemoglobin. It is present in foods such as fish and meat - especially liver. Its absorption rate is 25%, while the absorption of non-heme iron is from 1% to 15%, depending on the type of product consumed.
With this difference in absorption, non-heme iron makes up a significant portion of dietary iron. In addition, one should remember about the valence of iron - bivalent is absorbed better, and trivalent, respectively, is worse.
To increase the absorption of this trace element, it is necessary to control the composition of the food consumed in order to monitor which products enter the intestine at the same time. Their combination affects the percentage of dissolution of non-heme iron. For example, Vitamin C, which is an essential catalyst for the absorption process, is of great importance. This is due to the oxidation of iron elements and its transformation from a trivalent form to a divalent one.
On the other hand, consuming a lot of foods containing copper, zinc, or manganese can make it harder for the body to absorb iron. The fact is that these elements come from the intestines into the body with the help of a special transporter protein, which is also responsible for the entry of iron into the initial part of the small intestine. Thus, a large amount of zinc and copper creates too much load on this protein, making it difficult for it to perform its function of transporting iron.
Calcium has a similar property. However, in this case, one should be extremely careful - during pregnancy, a shortage of this element should not be allowed.
Calcium is an important resource for a heavily stressed body. Therefore, it is worth resorting to, so to speak, separate nutrition and consuming calcium after consuming iron, making sure that more than 4 hours have passed between meals or a vitamin. In practice, this is expressed much more simply - before eating foods or medicines containing iron, it is better to bypass foods that contain calcium: dairy foods, cheeses and green vegetables.
During pregnancy, you should be aware of the division of products into those that promote the absorption of iron and those that hinder this process. The first ones include:
- especially meat and fish. They contain such important proteins as myoglobin and hemoglobin, as well as vital lysine, cysteine and histidine. These are amino acids that promote the absorption of iron;
- fermented milk products such as kefir, fermented baked milk, acidolact;
- foods containing vitamin C (they include the acids necessary for the absorption (citric, acetic), namely, citrus fruits, bell peppers, plums, apples, pears, bananas, beets, carrots, tomatoes, pumpkin, potatoes and even sauerkraut. This food is also important for its content of essential simple carbohydrates, in particular fructose.
At the same time, they have a negative impact:
- cereals, bran, corn;
- legumes - they contain phytic acid and its derivatives - phosphates and phytates, which impede the absorption of iron, as well as coarse dietary fiber;
- tea, both black and green;
- green leafy vegetables and spinach - it contains polyphenols and oxalic acid;
- products containing calcium (milk, both hard and soft cheeses, cottage cheese), as well as eggs - they include complex phosphoprotein proteins;
- disodium ethylenediaminetetraacetic acid, used in canned foods as a preservative.
What causes iron deficiency anemia
As we have already said, anemia is a disease in which the level of hemoglobin in the blood is low. A special case of the disease - iron deficiency anemia - occurs due to a lack of iron necessary for protein synthesis.
Most prone to developing this disease are women suffering from chronic tonsillitis, heart defects, diabetes, gastritis, rheumatism, etc., as well as women with abundant menstrual flow.
In addition, at risk are often pregnant women who are already iron deficient during previous childbearing, pregnant at an early age and pregnant while breastfeeding. The prerequisites for the development of anemia can be a low level of hemoglobin in the first trimester (below 120 g / l), severe toxicosis in the early stages, threats of miscarriage and viral diseases transferred at this time, as well as multiple pregnancy and polyhydramnios.
The disease can also make itself felt due to the low consumption of meat - therefore, strict vegetarians should be especially careful - and as a complication after suffering pyelonephritis, viral hepatitis and dysentery.
How to treat iron deficiency anemia
The treatment process takes a long time and is carried out by taking drugs containing ferrous iron. However, if you do not speed up recovery, then you can definitely ease the expectation of its onset with the help of a simple but incredibly healthy diet.
First of all, it is necessary to include proteins in the diet that favorably affect the synthesis of hemoglobin - they should be about 130 g per day (a little more can be), and about 90 g should come from animal proteins.
It should be borne in mind that anemia often causes the deposition of excess fat in the cells of the bone marrow and liver. Therefore, it is worth reducing the consumption of fats (no more than 80 g), and, conversely, increasing the intake of foods that help normalize cholesterol and lipid metabolism in the body. This is cottage cheese oatmeal and buckwheat, vegetable oil, lean meat and fish.
Of course, products containing iron and vitamins of groups C and B, in particular B12, are mandatory - first of all, these are liver and brains (exclusively beef), beef meat itself, fish, bran, millet. It is also necessary to consume such trace elements as cobalt, copper and manganese, as well as the above products that contribute to the high absorption of iron.
What to eat with anemia - the right diet
Despite the fact that with anemia it is natural to lack appetite, it is necessary to adhere to a clear nutrition schedule, based on the following schedule:
- two breakfasts with a break of two to three hours. The dishes that make up the first tomorrow should be denser and more satisfying; light, steamed fish or fresh vegetables are recommended for the second breakfast;
- lunch, which necessarily includes soup or chicken broth, a second course and fruit;
- light afternoon snack (jelly, fresh fruit, tea with crackers);
- dinner, which includes several dishes (cottage cheese, vegetables and meat);
- a glass of kefir or fermented baked milk before going to bed.
At the same time, you should not panic and limit yourself in everything - there are no fundamental dietary restrictions for iron deficiency anemia. From the diet it is worth excluding only what is contraindicated for all pregnant women - strawberries, raspberries, coffee and cocoa, chocolate and seafood. At the same time, bread, like simple carbohydrates, does not belong to such products. On the contrary, it can be useful in reasonable doses - both black and white, but not more than 200 g per day.
Thus, the main rule to be followed is to know the measure in everything. For example, you should not eat only meat, as the main source of iron, because there will be absolutely no benefit from this, and you can only harm your health. There is no need to try to eliminate iron deficiency only through diet - for this you will have to increase the amount of food consumed several times, because. the percentage of the suctioned element always remains the same. Therefore, the most correct way is a combination of competent nutrition with the intake of medications prescribed by a specialist.
The range of iron-containing medicines is very large, so trying to choose them for yourself can be dangerous - you must definitely entrust this to your doctor.
The ideal option, of course, is the prevention of anemia. When planning pregnancy, you should keep it in mind in any case, not to mention those cases where a woman falls under at least one risk factor. Both before pregnancy and during, it is necessary to do a biochemical blood test for such an important indicator as serum iron - this will give a complete picture of the content of the element in the body.
In addition, it will not be superfluous to periodically check the general blood test for the level of hemoglobin and red blood cells. This will help keep the situation under control and prevent the possible development of this serious disease.
The hemoglobin level of a pregnant woman is checked at every routine laboratory blood test. It is an important indicator of the patient's state of health in position. The danger to the full development and normal intrauterine life of the fetus is a low level of the substance.
Why does hemoglobin level drop in patients in position? How can you increase iron during pregnancy? What drugs are best used to prevent anemia?
What is hemoglobin?
Hemoglobin is an iron-rich protein that is a component of the red blood cell. Its level is extremely important for the body, since iron forms compounds with oxygen and carbon dioxide, that is, with its help, the entire body is saturated with oxygen and removes carbon dioxide. Optimum oxygenation ensures a healthy appearance, physical and mental activity. Hemoglobin deficiency is called anemia or iron deficiency anemia.
The disease threatens a pregnant woman with the following complications:
- the risk of developing preeclampsia in the later stages;
- delayed growth and development of the baby;
- oxygen starvation of the fetus;
- placental abruption, risk of preterm birth;
- fetal death in 12% of cases;
- difficult childbirth, the threat of bleeding, weak labor activity;
- lactation problems.
Norms of hemoglobin levels for pregnant women
Low hemoglobin during pregnancy is dangerous for the development of anemia, so a blood test with the control of this indicator is mandatory before each scheduled visit to the gynecologist. The level of hemoglobin is measured in the following units - g / l (grams per liter of blood).
In a pregnant patient, the normal value ranges from 120-140 g / l. In obstetrics, the normal hemoglobin level depends on the trimester. With the growth of the fetus in the female body, the amount of blood increases, so a decrease in hemoglobin is a natural phenomenon. If a decrease in hemoglobin is observed in the analysis of the patient in the third trimester, the pregnant woman should not be alarmed. In gynecology, there are the following indicators of the norm:
- first trimester - 115-135 g / l;
- second trimester - 110-130 g / l;
- third trimester - 110-125 g / l.
If the patient's hemoglobin dropped for no reason and sharply, the doctor diagnoses her with anemia. Anemia has three forms:
- mild degree - 90-110 g / l, the patient does not have a deterioration;
- the average degree is 70-90 g / l, the woman has the first symptoms of the disease, which most pregnant women attribute to fatigue;
- severe degree - below 70 g / l, at this stage the patient observes all the signs of the disease.
A severe form of anemia is dangerous for its consequences for the child. Such a decrease in hemoglobin levels threatens miscarriage or intrauterine fetal death, so this condition requires emergency hospitalization and medical care.
Causes and symptoms of a decrease in hemoglobin
A low hemoglobin level is a fairly common problem for expectant mothers. Anemia is most often diagnosed in the second trimester after the 20th week. Reasons for low hemoglobin levels include:
- strict diet, malnutrition;
- insufficient amount of protein food;
- elevated calcium levels, which prevent iron from being properly absorbed;
- internal bleeding;
- pathologies of the digestive system, problems with the absorption of products;
- severe toxicosis;
- multiple pregnancy;
- the presence of chronic diseases, their exacerbation during the period of bearing a child;
- a short interval between the birth of children;
- an increase in estrogen due to hormonal disorders;
- unsuitable working or living conditions, stress, fatigue.
All of the above signs are non-specific. Specific manifestations of anemia include:
- change in the color of the skin, the appearance of characteristic pallor, cyanosis;
- discoloration of the mucous membranes;
- the occurrence of shortness of breath during a normal step;
- dizziness, tinnitus, fainting when changing body position;
- lack of appetite, loss of interest in familiar and favorite food;
- change in taste preferences - patients want to eat something that is not suitable for food (coal, chalk, earth, etc.);
- pathology of smell - women begin to like a sharp and rich chemical smell;
- impaired attention, memory, disorientation;
- sharp jumps in temperature without symptoms of SARS;
- seizures in the corners of the lips or weeping wounds;
- change in the structure of the nail plate - it becomes soft and pale;
- noticeable hair loss.
How to increase the hemoglobin of a pregnant woman?
Many patients in position are interested in the question of how to increase hemoglobin. As soon as a woman in position begins to notice specific and non-specific symptoms in herself, indicating a decrease in iron levels, she should immediately contact a gynecologist. Despite the existence of a huge number of pills to increase hemoglobin, a pregnant woman should never self-medicate.
At the first suspicion of anemia, the doctor will refer the woman to a laboratory test, the results of which make a diagnosis. Therapy of anemia should be aimed at eliminating its cause. The use of drugs with iron with low hemoglobin in most cases is insufficient. Patients in position who have a reduced level of hemoglobin, as a rule, are additionally prescribed medications for the treatment of pathologies of the gastrointestinal tract.
Products to increase hemoglobin
In order to quickly raise hemoglobin in the blood, a woman in position should normalize her diet and replenish her diet with healthy foods.
With a low rate of iron-containing protein in the blood, adherence to a hemo-diet is a necessity, since not a single vitamin complex can compensate for the intake of nutrients from food. Foods that increase hemoglobin in the blood include:
- beef, veal, turkey;
- any legumes - red and green lentils, asparagus, beans, peas, etc.;
- buckwheat and oatmeal, which are especially good for breakfast;
- nuts - walnuts, almonds, cashews, hazelnuts, good for snacking;
- any green vegetables;
- beets;
- all greens;
- apples, grapes, watermelon, pomegranate;
- blueberries, cranberries, strawberries;
- low-fat cottage cheese, hard cheeses;
- dark chocolate - in a small amount;
- yolks of chicken or quail eggs;
- seafood - shrimp, cod, squid - heat-treated.
Meat and seafood must be subjected to heat treatment without fail. Fruits and vegetables for pregnant patients should be consumed raw.
Vitamin complexes
In order to understand why hemoglobin falls and what needs to be done to raise it, this process should be analyzed in more detail. The bone marrow produces blood cells when the body lacks oxygen. At the same time, the kidneys begin to produce a special hormone that sends a signal to the bone marrow, they say, new red blood cells are needed. Before getting into the bloodstream, the erythrocyte must mature, develop and accumulate hemoglobin inside itself. The maturation of red blood cells is impossible without B vitamins:
- cobalomin - B12;
- folic acid - B9;
- pyridoxine - B6;
- riboflavin - B2.
Vitamin C also contributes to the high-quality treatment of anemia. Thus, the hemo-diet during pregnancy becomes effective only with the simultaneous use of vitamin complexes.
Iron preparations to increase hemoglobin
With moderate to severe anemia, doctors resort to prescribing medications. Patients with an average degree of iron deficiency anemia can take tablets and syrups (we recommend reading: anemia of 1, 2 and 3 degrees during pregnancy). Women whose hemoglobin level has fallen to 70 require hospitalization and intravenous medication. Drugs that raise the level of iron-containing protein in the blood are:
- Sorbifer Durules;
- Maltofer;
- Ferrum Lek;
- Totem.
There is no single answer to the question of which drug works better and faster. The choice of medication depends on the overall clinical picture of the disease. All of the above drugs have one thing in common - their effect weakens against the background of the use of dairy products and black tea. To increase the effectiveness of drugs, doctors usually prescribe vitamin C and folic acid.
Folk remedies
Traditional medicine is based on the use of special vitamin decoctions that have a beneficial effect on the body. The best way to raise hemoglobin is a variety of mixtures based on honey and nuts, freshly squeezed juices. If a pregnant patient has a low hemoglobin level, doctors may prescribe the following remedies to her:
- A decoction of the leaves of strawberries and currants. A handful of fresh leaves must be poured with 500 ml of boiling water and kept on low heat for about 15-20 minutes. The drink should be consumed 200 ml half an hour before meals.
- Honey. An effective remedy is 1 tsp. honey with a crushed clove of garlic, which should be eaten on an empty stomach.
- Honey based mixture. 0.5 st. green buckwheat and walnut meal should be ground with a blender or coffee grinder and mixed with 500 mg of honey. The mixture should be consumed in tsp. in the morning before meals.
- A mixture of freshly squeezed apple, beet and carrot juices. Juices must be mixed in equal proportions and drunk twice a day.
Prevention measures
The best way to prevent low hemoglobin levels during pregnancy is to be attentive to your health even at the planning stage of the baby. Firstly, the expectant mother should take a blood test 1-2 times a year. Identification of hidden pathological processes at the planning stage or in the early stages of pregnancy allows you to adjust the intake of vitamins and minerals in the body.
Secondly, the patient should be promptly treated for diseases of the gastrointestinal tract, especially dysbacteriosis. Thirdly, the expectant mother should take the necessary vitamin complexes in accordance with the gestational age. So, in the early stages, the patient in position should not be neglected folic acid.
The level of hemoglobin determines the presence or absence of anemia in a woman.
Normally, a woman should approach childbirth with one that will allow her to endure natural blood loss during childbirth without any problems for herself.
But low hemoglobin is a common occurrence during pregnancy. How dangerous is this for a woman and a child, what is it connected with and what needs to be done to prevent the development of anemia?
Hemoglobin is a special protein responsible for the transport of oxygen in the human body. Hemoglobin is located in red blood cells - erythrocytes. A drop in hemoglobin levels occurs with the development of anemia.
During pregnancy, a decrease in hemoglobin levels is considered a natural physiological process - this is due to the rapid increase in mother's body weight and an increase in circulating blood volumes.
As a rule, a noticeable decrease in hemoglobin is observed in the 2nd trimester after 20 weeks. It was at this time that the placental circle of blood circulation develops and the volume of blood in a woman begins to increase significantly.
During this period, blood volume can almost double, which creates a certain load on the hematopoietic organs and the cardiovascular system.
To facilitate the work of the heart, the body takes a number of actions.
Physiologically, the vessels relax, and the composition of the blood changes - it becomes less viscous. In the blood, the amount of plasma - the actual fluid - increases.
The number of red blood cells itself does not change, but against the background of an increased amount of blood, this leads to the fact that the hemoglobin level drops.
The risk of anemia increases. As a rule, the risk is higher in those women who, even before pregnancy, had a tendency to develop it.
Physiologically, the lowest hemoglobin during pregnancy occurs at 32-34 weeks. This is considered the norm if there is no disturbance in well-being and a fall below certain numbers.
Normally, for childbirth, the level of hemoglobin also increases physiologically due to changes in the composition of the blood and its viscosity, which is due to the preparation of the body for the birth of a child.
If the hemoglobin level falls below 110 g / l, this is no longer considered physiologically low hemoglobin, which is acceptable during pregnancy, but a violation that can lead to sad consequences.
It is now established that about 40% of all pregnant women have low hemoglobin.
Causes
The causes of low hemoglobin that contribute to a decrease in hemoglobin levels in the blood include:
- iron deficiency in the body;
- lack of folic acid involved in the processes of hematopoiesis;
- lack of zinc, vitamin B12, trace elements such as copper;
- multiple pregnancy;
- irrational nutrition;
- frequent pregnancies;
- during which beneficial substances are washed out of the body;
- nervous stress;
- dysbacteriosis;
- chronic diseases of the gastrointestinal tract - gastritis, peptic ulcer, etc.;
- unfavorable ecology or work in hazardous production;
- infectious diseases of the mother;
- autoimmune diseases of the mother;
- bleeding during pregnancy;
To provoke a drop in hemoglobin can take a number of drugs, especially cytostatics, chloramphenicol.
Low hemoglobin levels are often observed in women who are fond of vegetarianism due to the fact that plant foods contain very little iron.
Low Level Signs
Normally, the level of hemoglobin during pregnancy should be at the level of 110 g / l and above.
If it falls below these figures, then we are already talking about the development of anemia in pregnant women.
There are several degrees:
- Light (hemoglobin at the level of 100-90 g/l);
- Moderate (90-70 g/l);
- Severe (less than 70 g/l).
A mild degree may not be noticed, because a woman may not feel her symptoms. She may take some weakness and pallor for a natural state during pregnancy, just like a change in taste preferences.
If hemoglobin falls below 90 g / l, the symptoms of anemia are already beginning to manifest themselves clearly.
You can identify the problem by a number of signs:
- pallor - at the same time, not only the skin turns pale, but also the lips;
- frequent dizziness;
- weakness and a drop in efficiency - a woman feels unwillingness to move, it is easier for her to sit or lie down;
- dry skin;
- fragility of nails;
- hair loss;
- the appearance of jam in the corners of the lips;
- perversion of taste up to eating inedible things such as chalk;
- flashing flies before the eyes;
- palpitations, shortness of breath and sometimes, in severe cases, heart pain;
- noise in ears;
- sleep disorders;
- fainting.
In order to prevent the development of anemia and its aggravation during pregnancy, it is required to donate blood for hemoglobin once every 3 months.
What is dangerous?
A decrease in hemoglobin and its prolonged deficiency leads to undesirable consequences and a violation of the development of pregnancy.
A developing child begins to experience a lack of oxygen and nutrients.
The result will be:
- lack of fetal weight - malnutrition and the risk of impaired development of internal organs.
Low hemoglobin in the early stages is not physiological and almost always becomes a sign of anemia that threatens the child.
In the early stages, low hemoglobin can cause:
- Toxicosis;
- placenta previa;
- miscarriages;
- Violations of cell growth in the fetus and its hematopoiesis.
Throughout pregnancy, low hemoglobin causes:
- Chronic placental insufficiency, which can provoke placental abruption;
- fetal hypoxia;
- Hypoplasia of the placenta;
- Developmental delays in the child.
In the later stages, low hemoglobin can provoke:
- preeclampsia and eclampsia of pregnant women;
- early rupture of amniotic fluid and;
- weakness of labor activity, which will require stimulating measures or even a caesarean section;
- risk of bleeding during childbirth;
- risk of bleeding after childbirth;
- asphyxia of the child at birth;
- death of a child within a few hours after birth due to imperfection of the hematopoietic system caused by a constant deficiency of hemoglobin in the mother during pregnancy.
The weight of the child at birth in mothers who suffered from anemia is below normal, the child is more susceptible to infections.
The mother herself may develop hypogalactia - milk will be produced little or not begin to be produced at all in severe forms of anemia.
In addition, a woman suffering from anemia will take much longer to recover from childbirth. She has a higher risk of developing postpartum complications, prolonged bleeding.
Donating blood - how many times?
Based on the foregoing, it becomes clear why doctors pay such attention to controlling the level of hemoglobin in a woman.
Therefore, a complete blood count is mandatory in each trimester.
If violations are detected, a corrective diet is prescribed and, in more severe cases, medications. Hemoglobin level control in this case is done more often: 2-4 weeks after the appointment of treatment.
How to level up?
The following measures help raise low hemoglobin levels during pregnancy:
- adherence to a complete diet;
- rejection of vegetarianism;
- taking medications containing iron;
- taking medications containing folic acid and B vitamins.
Contributes to a special diet.
The diet of a pregnant woman should contain foods rich in protein, vitamins and iron.
Most iron in beef, liver, fish, turkey, cocoa, eggs, buckwheat, almonds, apples, apricots, pomegranate.
With low hemoglobin, the diet must necessarily include. For example, pregnant women need to eat beef at least 3-4 times a week, and monitor the daily intake of protein foods - any meat or fish.
But at the same time, we must remember that the norm of protein per day is no more than 125 g.
Therefore, portions should not be large. If you eat protein foods in excess of the norm, then this causes proteinuria - which can lead to pathology of pregnancy.
The diet should contain enough carbohydrates and fats. At the same time, in the norm of fats, no more than 80 g should be consumed, so it is best to use lean meats.
The need for carbohydrates must be satisfied at the expense of slow carbohydrates contained in cereals, vegetables, fruits, and in no case at the expense of fast carbohydrates contained in sugar, sweets, flour products.
Foods that increase hemoglobin include vegetables, fruits and all kinds of greens.
Plant foods contain vitamin C and. And these elements improve the absorption of iron from other products.
For the prevention of anemia and for the treatment of its mild degree, multivitamins are prescribed, including folic acid, iron, copper, ascorbic acid, B vitamins, zinc.
If these measures are not enough, then the doctor may prescribe - sorbifer, ferroolgamma, totem, maltofer, ferrum lek, Ferroplex.
It is worth remembering that such drugs are taken for at least 2 months, since the effect of them will be felt after 6-8 weeks. All of them are taken in the form of tablets.
Injections are prescribed in extreme cases, when anemia threatens the health of the mother and child, or when iron malabsorption, gastric and duodenal ulcers are diagnosed.
As a rule, the intake of iron-containing preparations is carried out with the simultaneous administration of funds containing folic and ascorbic acids.
There are few side effects of the drugs - they are usually well tolerated. These include:
- skin redness;
- loss of appetite;
- or ;
- pain in the epigastrium;
- allergic reactions (very rare);
- exacerbation of chronic gastritis;
- darkening of feces and urine;
- darkening of teeth.
If these signs appear, stop taking the drug and consult a doctor.
Contraindications to taking medications orally are:
- intolerance to iron preparations;
- peptic ulcer;
- acute inflammatory diseases of the stomach and intestines - exacerbation of gastritis, colitis.
A low level of hemoglobin requires an attentive attitude. In this case, it is impossible to independently prescribe treatment for yourself - you need to consult a doctor and strictly follow his recommendations. In this case, you can be sure that the pregnancy will proceed without complications.
The description of pregnancy as a period of joyful expectation of a baby, unfortunately, does not always correspond to reality. For a long 9 months, a woman is faced with various ailments that she had not encountered before.
One of the important indicators of a woman's health is the normal level of hemoglobin in the blood, which for various reasons may deviate from the norm. This will not bring special problems for the unborn child if you see the changes in time and take the necessary measures.
Hemoglobin and its meaning
Hemoglobin is a complex protein that is a component of the blood and is responsible for delivering oxygen to all organs. Carriers of hemoglobin are small red bodies called erythrocytes. Depending on their amount in the blood, one can also judge the level of hemoglobin, which is necessary for the optimal functioning of all organs, growth and development of the baby. Accordingly, during pregnancy, the health and even life of the child may depend on the level of hemoglobin.
Depending on the lack of hemoglobin, there are three degrees of anemia:
- mild - hemoglobin index 90-110 g/l;
- medium - hemoglobin index 70-90 g / l;
- severe - hemoglobin index less than 70 g / l.
Features of the manifestation of anemia
Almost half of all pregnant women experience a lack of hemoglobin at one time or another. In order to diagnose the problem in a timely manner, registered women are offered to periodically take tests. The future mother can determine the lack of hemoglobin on her own, noting the following symptoms:
- constant weakness, very fast fatigue;
- periodic dizziness, the appearance of "flies" before the eyes;
- pallor of mucous membranes, skin;
- palpitations, the possibility of fainting;
- the appearance of tinnitus, as well as shortness of breath at the slightest physical exertion;
- headaches, insomnia;
- dryness and pallor of the skin, bluish color of the lips;
- brittle nails and split hair;
- constipation;
- strange taste preferences that have not previously been noted.
Causes of anemia
The amount of blood naturally affects the decrease in hemoglobin levels: the larger its volume, the less hemoglobin it contains. A growing baby with each week of pregnancy takes more and more iron. Especially often there is a lack of hemoglobin in multiple pregnancies.
Anemia can also be caused by a lack of certain elements in the body. For example, folic acid, zinc, copper, vitamin B12 are involved in the absorption of iron. Without them, the amount of absorbed iron is sharply reduced. That is why proper nutrition of the expectant mother plays a key role in preventing the appearance and development of anemia.
The main causes of hemoglobin deficiency are:
- serious diseases of internal organs: heart disease, hepatitis, pyelonephritis;
- toxicosis in the first months of pregnancy;
- a short break between two pregnancies (experts recommend taking a break of at least 3 years, during which the body is able to restore iron stores);
- constant stress;
- taking certain medications;
- dysbacteriosis.
Most often, pregnant women with iron deficiency encounter in the second half of pregnancy. After 20 weeks, the baby is already quite large. The mother's blood volume increases significantly, and iron intake increases, which leads to its deficiency. The maximum decrease in hemoglobin is usually noted by 32-34 weeks.
If the decrease in hemoglobin level occurred at the end of pregnancy, then special treatment in this case is not prescribed. Immediately before childbirth, its blood counts usually level off on their own.
A physiological drop in the amount of iron must be distinguished from changes that require medical intervention. Its deficiency can lead to oxygen starvation of the baby with the subsequent development of hypoxia. Anemia can cause late toxicosis, as well as untimely discharge of amniotic fluid.
A low level of hemoglobin can lead to complications during childbirth, for example, weak labor, premature birth, heavy bleeding, and even death of the baby in the first day of life.
A toddler can be born with a small weight, be extremely susceptible to infections. That is why you need to constantly monitor the level of hemoglobin in order to timely see its deficiency and calculate the rate of decrease in its amount in the blood.
Prevention and treatment of low hemoglobin in pregnant women
The safest way to treat anemia is to prevent it. It is necessary to take the complexes of vitamins and minerals recommended by the doctor. The range of foods rich in iron is quite diverse, so there should be enough of them in the diet of the expectant mother. Among them are buckwheat, meat, liver, fish, apricots, eggs, rye, beets, peaches, dried mushrooms, parsley, carrots, legumes, pomegranates, pomegranate juice, and persimmons.
Iron is best absorbed from animal products - up to 6%, while plant foods can only provide 0.2%. Walking in the fresh air, taking ascorbic, folic acid also contribute to the increase in digestibility.
Doctors note that without iron-containing drugs, the treatment of anemia is impossible, since an insignificant amount of the necessary iron enters the body with food. Treatment can last for several months. If a woman does not tolerate pills, then injections are used.
During pregnancy, any woman carefully monitors her health. And the more terrible it is to hear from the doctor the words that something is wrong with the analyzes. A sufficient level of hemoglobin is one of the most important indicators of the normal life of any person. As for the future mother, it is of key importance for the normal bearing and development of the unborn child.
Why is low hemoglobin dangerous during pregnancy, how to raise it to the required level, and what could be the consequences for the baby? These questions are asked by any pregnant woman who has encountered this problem.
Low hemoglobin - what is it?
Hemoglobin is a special protein found in red blood cells. He is responsible for the proper supply of human organs with oxygen. Accordingly, when it decreases, a person receives less oxygen and feels lethargic, tired, and powerless.During the period of gestation, a variety of changes occur in the female body, which do not bypass the blood. It becomes more viscous, the plasma volume increases. A low level of hemoglobin during pregnancy can lead to pathologies in the development of the fetus, because. he, along with the mother's body, does not receive the necessary oxygen.
To begin with, it is worth understanding exactly what is included in the concept of the norm, and which indicator is considered low or even critical. For pregnant women, a separate gradation applies. The hemoglobin of the expectant mother may fluctuate:
- In the first trimester, values from 112 to 160 g / l are allowed;
- The second trimester can be characterized by a level of 106 to 144 g/l;
- For the third trimester, a drop to 100 g / l is considered acceptable.
- Light. When such a diagnosis is made, erythrocyte counts can fall to the level of 90-110 g / l. As a rule, such a violation has no clinical manifestations, although some symptoms may still occur;
- Average. Such a diagnosis suggests that the level of hemoglobin in your blood has dropped to the level of 70-90 g / l. In this case, the first changes appear, which a woman may not pay attention to, writing them off as simple fatigue in connection with her position;
- Heavy. This diagnosis can lead to termination of pregnancy and threatens a woman with serious complications. Red blood cell counts in severe cases fall below 70 g / l.
Symptoms of low hemoglobin during pregnancy
Anemia, like any other pathology, has its own symptoms and signs. At the same time, not everyone and not always can notice them in time and understand what exactly is the matter.You can suspect a violation by the following signs:
- Changing the color of the skin and mucous membranes to a paler, cyanotic and even yellowish;
- Shortness of breath, shortness of breath;
- Dizziness, headaches;
- Increased fatigue, constant desire to sleep;
- Regular noise in the ears, "flies" before the eyes;
- Poor appetite or desire to eat unusual foods: sulfur, sand, chalk, ash, etc. There may also be interruptions in the work of the intestine;
- Increase in body temperature;
- Cramps in the legs and arms, body aches;
- Increased heart rate;
- Inattention, memory problems.
Causes of anemia during pregnancy
Low hemoglobin during pregnancy is quite common. A drop in red blood cells in the blood can be due to a number of reasons:- Eating habits and ways of assimilation of food in the body. For example, periodic malnutrition, lack of iron in the diet, lack of protein, high calcium, zinc and copper deficiency, etc.;
- Hidden bleeding, exacerbation of chronic diseases;
- Pathologies from the gastrointestinal tract, dysbacteriosis;
- Severe toxicosis;
- Multiple pregnancy;
- Short period between several pregnancies (less than 2 years);
- Hormonal failures;
- Regular stress and nervous strain;
- Malignant diseases of the blood;
- Taking certain medications.
What threatens low hemoglobin during pregnancy
Anemia of mild degree, as a rule, does not cause significant complications. But if the level of red blood cells falls below a critical level, and treatment is not carried out, then very serious disturbances in the functioning of the female body and the further development of the fetus are possible.The consequences of low hemoglobin during pregnancy for a woman can be:
- Decreased immunity, constant fatigue;
- The appearance of heart failure, liver enlargement;
- Problems from the gastrointestinal tract, constipation;
- swelling of the extremities;
- Violation of the brain, atherosclerosis of blood vessels.
- Premature birth, tk. anemia provokes placental abruption;
- Gestosis, because as a result of anemia, all organs experience oxygen starvation - hypoxia. As a result, water metabolism is disturbed, edema appears, and phytoplacental insufficiency develops. A severe form of preeclampsia can lead to preeclampsia and eclampsia, in connection with which the pregnancy is interrupted regardless of the term;
- Complications during childbirth. Due to the development of anemia, weakening of labor activity, the development of bleeding is possible;
- Violation of lactation. Women with iron deficiency have problems with lactation;
- Complications after childbirth. Due to a decrease in immunity against the background of anemia, the risk of infections entering the body increases.
Low hemoglobin during pregnancy: consequences for the child
Not only the woman, but also her baby suffers from anemia. Oxygen starvation for a long period of time causes a number of serious disorders in the child. They are caused by a lack of nutrients necessary for the full formation and development.For the fetus, possible complications are:
- Hypoxia of the brain;
- Fading pregnancy;
- Insufficient body weight;
- Pathology of the respiratory organs and central nervous system;
- Atrophy of muscle tissue;
- Mental underdevelopment;
- Stillbirth - in 12% of cases.
What to do if hemoglobin is low during pregnancy
The very first rule is not to panic! After receiving the results of the tests, it is necessary to discuss the treatment with the attending physician and strictly follow the recommendations.Proper treatment combines a balanced diet and taking certain medications. To achieve a result, you must first find the cause of anemia. Self-treatment, for example, with a hematogen during pregnancy with low hemoglobin is an ineffective method.
Very often, with anemia, iron preparations are prescribed in the form of tablets: Sorbifer Durules, Ferrum-Lek, Ferroplex, Fenyuls, Totema. All of them are quite effective, but your doctor should select and prescribe them. You can not self-medicate, because. it can only harm you and the baby.
Important! Do not take your anemia medication with milk, tea, or coffee. they interfere with the absorption of iron in the intestines. Drink them with clean water.
What to eat with low hemoglobin during pregnancy
Food along with medications is essential in the treatment and prevention of anemia. To raise the level of hemoglobin, it is worth diversifying your diet with the following foods:- Green vegetables;
- Beef tongue and liver, red meat;
- Chicken yolks;
- Nuts;
- Beet;
- fish;
- apples;
- Buckwheat;
- legumes;
- Pomegranate;
- Berries, and especially strawberries and black currants;
- Carrots.
There are folk remedies to increase the level of red blood cells. These include a mixture of buckwheat flour and walnuts, filled with honey; raw porridge made from dried apricots, almonds, raisins and honey; beet-carrot juice; apple-cranberry fresh; a mixture of lemon peel, dried apricots, dates, raisins and honey and others.
In order to prevent the development of anemia in advance, it is necessary from the very first days of pregnancy to eat foods containing iron, folic acid, vitamins C and B. It is also necessary to walk more in the fresh air, avoid stress and have a good rest.
Low hemoglobin during pregnancy is a very common problem. Be attentive to yourself and your baby, undergo examinations in a timely manner, maintain only a positive attitude, and you will be able to solve it quickly and efficiently!