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Gestational age 42 weeks, referred to eldctive CS. Decrease in Hb levels. Anemic?

ok , i am a STN and i have a case she is 26 years old and her GPA = G3P1A1 and she is now a pregnant , her gestational age is 42 week with now contraction so she refered to elective CS , her blood test shows a decrease in HGB = 11.3 and her HCT = 33 , the question is do this mother consider anemic or its normal physiological changes according to her pregnancy ?
Asked On : Thu, 22 Nov 2012
Answers:  2 Views:  34
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OBGYN 's  Response
May 2013
Thanks for the query.

As you know physiological hemodilution occurs in pregnancy.
So in third trimester, hemoglobin of above 11 gm/dl can be considered as normal only.
Better to estimate clinically also, as sometimes lab reports may differ from clinical findings.

Take care.
Answered: Mon, 3 Dec 2012
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OBGYN Dr. Aarti Abraham's  Response
Mar 2013
I appreciate your query
WHO has accepted up to 11gm percent as the normal haemoglobin level
in pregnancy. Therefore any haemoglobin level below 11gm in pregnancy should be
considered as anaemia. However in India and most of the other developing countries the
lower limit is often accepted as 10 gms percent.
Degree of Anaemia: Anaemia is often classified as mild degree (9-11 gm %), moderate
(7-9 gms %), severe (4-7 gm %) and very severe (
to Haematocrit (PCV) %.
Hence, going by the reports of your patient, ( Hb - 11.3 ), she is just on the verge of being classified as anaemic going by the definition.
Moreover, she has been planned for an elective CS
An average Caesarean section can entail a blood loss ranging from 500 ml - 1000 ml of blood, and the fall in Hb can range from 1 - 2 Gm %, which will definitely exacerbate the anemia.
Hence, you should have a skilled surgeon and anesthetist ready, plus have her Blood Grouping and Cross Matching ready in case you need to transfuse blood products.
Hope this helped you.
Answered: Mon, 3 Dec 2012
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