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Gynecology (Expert Forum)
Anemia and Pregnancy
Answered by
Keith Downing, MD - Obstetrics, Gynecology
MA
This forum is for questions and support regarding gynecology issues such as: Cervical Disorders, Colposcopy, Cramps, Cystitis, Fallopian Tube Disorders, Menstruation, Ovarian Disorders, PAP Test, Pelvic Exam, PID, PMS, Surgery, Tests, Ultrasound, Uterine Disorders, Vaginal Disorders.
Anemia and Pregnancy
by cmpeder, May 20, 2008 02:47PM
I am 25 years old and this is my first pregnancy. A little over a month ago i was told that I was anemic. My numbers were: Hematocrit 25.4; Hemoglobin 9.2 RBC 2.78. My MCV, Iron and Folate were perfect. But my Ferritin was Low at 6, and My B-12 was also low at 168. I was told to take repliva, folate, and B-12, which I have religiously. After a month of this they took my CBC and my Hemoglobin and Hematocrit have not changed, but I was only told to continue what I was doing. I am so weak, but the doctors dont seem to care. And, I am worried about labor. I am now 35 weeks. I feel like I am running out of time to get these numbers up and what we are doing is not working. Why are we not talking about more aggresive measures? The doctor told me today not to worry that I wasn't even really that anemic; that it is just a part of being pregnant. But, everything I have read says it is not normal, and I should worry. I think I am being brushed off. Would you be more concerned going into Labor with a hemaglobin level at 9.2? Should I see a hematologist?
Doctor's Answer
by Keith Downing, MD, May 21, 2008 03:39PM
, May 21, 2008 03:39PM
Hello,
There is a physiologic anemia that occurs with pregnancy (from a greater increase in blood plasma volume than the increase in red blood cells) such that it is very common to see women with hgb levels around 9-10 as they near term (the maximal dilution occurs around the start of the third trimester). You have been placed on a regimen to maximize your iron storage capacity, and this is helpful despite the fact your hematocrit did not bump substantially. I suggest you express your concerns with your ob/gyn again. Confirm you have had a hemaglobin electrophoresis study done and continue to take the supplements. From what you have told me I don't feel you are being managed inappropriately. I'd simply encourage you to continue a dialogue with your ob/gyn.
Best regards,
Dr. Downing
There is a physiologic anemia that occurs with pregnancy (from a greater increase in blood plasma volume than the increase in red blood cells) such that it is very common to see women with hgb levels around 9-10 as they near term (the maximal dilution occurs around the start of the third trimester). You have been placed on a regimen to maximize your iron storage capacity, and this is helpful despite the fact your hematocrit did not bump substantially. I suggest you express your concerns with your ob/gyn again. Confirm you have had a hemaglobin electrophoresis study done and continue to take the supplements. From what you have told me I don't feel you are being managed inappropriately. I'd simply encourage you to continue a dialogue with your ob/gyn.
Best regards,
Dr. Downing
