Anemia is the commonest disorder in pregnancy. Its prevalence in India varies between 50 to 70%. It  is an important factor for maternal and prenatal morbidity and mortality so, there is major difference in developed and developing countries. Anemia during pregnancy is especially a concern because it is associated with low birth weight, premature birth and maternal morality. Anemia in pregnant is more common in poor socio-economic status.

Anemia is a medical condition in which there is not enough healthy red blood cells to carry oxygen to the tissues in the body. In anemia you can feel tired and weak, if it goes unseated. It can increase your risk of serious complications. It is normal to have mild anemia when you are pregnant. But you may have more severe anemia due to low iron or vitamin level. All pregnant women are at high risk for becoming anemic because they need more iron and folic acid than usual.

Types of Anemia in Pregnancy:

• Iron deficient anemia: Iron deficient anemia is the most common cause of anemia during pregnancy.
• Folate deficiency: Folate is the vitamin found naturally incertain foods like green leafy vegetables. During pregnancy it’s demand increases. Folate deficiency causes certain type of birth defects such as neural tube abnormality and low birth weight baby
• Vit B₁₂ deficiency: Body needs Vit B12 to form healthy RBC. Woman who don’t eat meat and poultry, dairy products and eggs may have Vit B12 deficiency which may contribute to birth defects and preterm labour. When the Hb level is less then she is called anemic.

Causes of Anemia in Pregnancy:

• Chronic blood loss due to parasitic infection
• Multiple pregnancy
• Multiplicity
• Acute blood loss in APH, PPH
• Recurrent infections (UTI)
• Hemolytic anemia in PIH
• Hemoglobinopathies like thalassemia

Signs and Symptoms:

Weaker, loss of appetite, dizziness, palpitation, breathlessness, swelling of feet & eye lids, generalized swelling of body, symptoms of congestive cardiac failure.

Signs: pallor, glossitis, stomatitis, oedema, hypoproteinemia, soft systolic murmur, pale nails.

Investigations:

Hb & haematocrit should be done at the first visit. Type of anemia is confirmed by doing s. iron, s. Folate and s. Vit B₁₂ special investigations:

• Serum ferritin
• Serum Iron building capacity
• Percentage saturation of transferring, 35% – 50% decreases to less than 20% in iron deficient anemia
• RBC protoporphyrin 30µG/dl. If double and triples in Fe deficient anemia.

Other investigations:

• Urine
• Stool
• Bone marrow exam for refractory anemia
• X-Ray chest (Pulmonary T.B.)
• creatinine or BUN for renal disease.

Recommended diet for Anemic Patients:

Introducing diet in iron and fruits and leafy vegetables. Treat yourself with warm against infections , maintain general hygiene, food full of iron and genetic modifications of food.

Iron and folic acid:- Supplementation during pregnancy:

• Heme iron is better – present in animal food and is better absorbent.
• Iron absorption enhanced by citrus fruits and vitamin C
• Avoid tea, coffee, ca phytate, phosphates, oxalates etc.

Iron rich food:

• Green leafy vegetables – chana, sagg, sarson ka sagg, chaulai, turnip (salgam)
• Cereals – wheat, ragi, jowars, bajara
• Pulses – sprouted pulses, jaggery
• Animal flesh food – meat, liver
• Vit C: Lemon, orange, guava, amla, green mango etc.