Cause Of Anaemia In Pregnancy Research Articles

ASUHAN KEBIDANAN PEMBERIAN SARI KURMA UNTUK MENINGKATKAN KADAR HEMOGLOBIN IBU HAMIL DENGAN ANEMIA DI PUSKESMAS TANJUNG BALAI KARIMUN

According to WHO, the global prevalence of anemia in pregnant women worldwide is 41.8%. The main cause of anemia in pregnancy is iron deficiency, followed by folate deficiency. One way to overcome anemia in pregnancy is by consuming iron foodstuffs, including dates. The purpose of this study was to provide integrated midwifery care for pregnant women with mild anemia by giving date juice to increase hemoglobin levels. Midwifery care uses a midwifery management approach. This type of research uses case study qualitative data. Midwifery care was carried out at the Tanjung Balai Health Center with subjects pregnant women at 32 weeks of gestation with mild anemia. The research instrument uses a case study format and observation sheets. Data collection techniques use primary data through anamnesis, physical examination, interviews and observation. Evaluation of the care provided related to giving date palm juice 3 times a day can help increase HB levels. For health workers, it is hoped that they can improve the quality of midwifery services through a management approach to midwifery care for the prevention of mild anemia with date juice.

Anemia in Pregnancy: Cause and Effect

One of the most common complications associated with pregnancy is anemia. Severe anemia that occurs during pregnancy has adverse effects on both the mother and the fetus. This literature review aims to provide related information related to how anemia can occur in pregnancy, what are the risk factors and causes of anemia in pregnancy, and the impact of anemia on pregnant women and their fetuses. We searched from online databases and used review articles, research, guidelines from professional organizations, such as World Health Organization and Ministry of Health Republic of Indonesia. Result: In general, pregnant women will experience a decrease in hemoglobin concentration due to the physiological role of hemodelution during pregnancy. However, this condition will be worsened and make pregnant women fall into anemia when accompanied by other factors such as iron deficiency, folic acid deficiency, infection, non ideal BMI (Body Mass Index), and congenital blood diseases. As a result, severe anemia that occurs during pregnancy has adverse effects on both the mother and the fetus. Conclusion: It is important to understand the factors that cause anemia in pregnancy to avoid adverse effects on pregnant women and their fetuses or children.

Direct Effect of Iron Deficiency Independent of Anemia on Adverse Perinatal Outcomes- a Scoping Review

Introduction Iron is required throughout pregnancy by both the pregnant individual and the fetus. Iron stores can be depleted during pregnancy resulting in iron deficiency (ID), which is the most common cause of anemia in pregnancy. Iron deficiency anemia (IDA) is associated with an approximately two-fold increase in adverse perinatal outcomes (APO) such as low birth weight (LBW), preterm delivery, and stillbirth. It is uncertain whether depleted iron store in a non-anemic pregnant individual affects fetal growth and well-being. The effect of ID per se on these outcomes, independent of anemia, is the central focus of this scoping review. If an independent association between iron deficiency without anemia (IDWA) and these APO is established and given the potential for non-anemic iron deficiency to progress to IDA, early screening, and intervention before the development of IDA may be important in preventing these morbidities and mortality. Our objective is to determine the current state of existing knowledge concerning IDWA and APO. The specific aims are to determine the prevalence of IDWA in pregnant individuals, assess predictors and determine types of APO associated with IDWA. Methods We performed a comprehensive systematic scoping review of the independent effect of IDWA on APO. The search for relevant studies involved Ovid Medline, Cochrane Database of Systematic Reviews, Cochrane Control Register of Controlled Trials, and hand search of citations of relevant articles for cohort and cross-sectional studies, randomized controlled trials, systematic reviews, and meta-analyses, scoping and narrative reviews from the inception of the databases. We used all relevant Medical Subject Headings terms and subheadings with no language restrictions. Two reviewers independently screened titles, abstracts, and full text based on the outlined inclusion and exclusion criteria. The inclusion criteria include relevant studies reporting on IDWA in pregnancy and APO. Exclusion criteria include studies not reporting IDWA and APO, and the presence of medical conditions such as hemoglobinopathies, polycythemia, iron overload, autoimmune and inflammatory conditions. Discrepancies were resolved through discussion and consensus. Covidence ® systematic review software was used for screening, automatically eliminating duplicates and data extraction. PRISMA for Scoping Reviews reporting guidelines was used. The selection process and results of included and excluded studies were presented with a PRISMA flow chart. A narrative summary was conducted to descriptively summarize the findings. Results A total of 4389 articles were identified from the searched databases after all duplicates were removed. Two studies conducted between 2005-2008 and 2017-2018 respectively met the inclusion criteria and were eligible for data extraction. A total of 5684 participants made up of 5479 Danish and 205 Spanish cohorts were included. The prevalence of IDWA in Denmark was 14.2% based on serum ferritin of <30μg/L and hemoglobin ≥110g/L and 20% in Spain using thresholds of SF <12μg/L and Hb≥110g/L. The mean (standard deviation, SD) age of participants was 31.8 ± 5.0 years in Denmark, and the mean (95% CI) was 31.0 (29.4-32.6) years in Spain. In the Danish study, the babies had a mean (SD) birth weight of 3508±523g and were on average 192g smaller (p=0.028). The mean (SD) gestational age (GA) at delivery was 39.8±1.7 weeks, adjusted odds ratio (95%CI) of LBW was 0.6 (0.4-1.0), stillbirth 4.0(1.0-14.3) and gestational diabetes mellitus 1.1 (0.7-1.7) in the IDWA group. The Spanish study reported a mean (95% CI) infant birth weight (IBW) of 3140 (3067-3213) g, reduction in adjusted IBW of -192.4 (-363.6, -21.2)g, p=0.028, R 2c.100 = 35.4, F 194,11 =9.3, p<0.001 in IDWA. Both studies reported the covariates and predictors of APO including parity, race, body mass index, and socioeconomic status. Conclusion Overall, there is limited research on this important obstetric hematology topic. The few available studies identified higher odds of non-causal association between IDWA, stillbirth, and smaller birth weight. Similarly, there was a non-significant causal association with most predictors and maternal medical complications of pregnancy. These findings will motivate further research work by our team. The study will involve the use of large population-based data to establish a potential causal association between IDWA and APO.

Comparison of Intake of Moringa Leaf and Green Beans as an Alternative to Increase Hemoglobin Levels of Pregnant Women With Anemia

Anemia is a "potential danger of mother and child". According to Riskedas (2018) anemia prevalence of pregnant women increased within 5 years from 37.1% to 48.9%. The biggest cause of anemia in pregnancy is iron deficiency anemia. One of the causes is lack of pregnant women get iron tablet (SF) less than 90 tablets and have not consume iron tablets correctly and continuously. Improving iron status can be done with non-pharmacological therapy, including the consumption of moringa and green beans. To compare the effectiveness of Moringa leaves and green beans on hemoglobin levels in pregnant women. Search for articles through the databases of Google Schoolar, Science Direct, PubMed, Elsevier (SCOPUS), Medline using Boolean operators (AND and OR). The research inclusion criteria were : Studies with randomized controlled trial (RCT) or quasi experiment design from 2015 to 2020, research participants were pregnant women, the intervention given was Moringa leaves or green beans. The results of the measurement of hemoglobin levels. Eighteen studies met the eligibility criteria and were analyzed. Moringa leaves were more effective in increasing the hemoglobin level of pregnant women with Standardized Mean Different (SMD) by 0.10 compared to green beans (SMD 0.10; CI 93% = -0.38 to 0.58; p<0.00001). Moringa leaves are more effective in increasing hemoglobin levels of pregnant women than green beans.

IDENTIFIKASI KANDUNGAN ZAT BESI DAN VITAMIN C PADA DAUN KELOR (MORINGA OLEIFERA) SEBAGAI PENANGANAN ANEMIA PADA IBU HAMIL

hemoglobin levels. Anemia in pregnancy is a condition where hemoglobin is below normal, which is below 11 g/dl. The most common cause of anemia in pregnancy is iron deficiency. Moringa leaves are one type of food that is rich in iron which can overcome anemia. Methods Methods The method in this study was to conduct laboratory tests on 100 grams of fresh Moringa leaves colored from light green to slightly dark green. Screening for Fe used Potassium tocyanide/Ammonium thiocyanate 2 NDragendorff reagent, while vitamin C with 10% povidone iodine reagent was equivalent to 1% iodine. Results The results showed that Moringa leaves (Moringa oleifera) contained Fe and Vitamin C compounds. Discussion/Suggestion The use of Moringa leaves is an alternative that can be used to prevent anemia, besides being cheap and easy to obtain. It is expected that pregnant women besides taking Fe tablets are also advised to consume foods high in iron such as Moringa leaves to increase hemoglobin in pregnant women. Further researchers are advised to conduct research related to development innovation

Iron Deficiency in Pregnancy: A Brief Review

This paper highlights iron deficiency anaemia in pregnancy; its prevalence, causes, screening, and management. Iron deficiency is a spectrum that ranges from iron depletion to iron deficiency anaemia. Iron deficiency is the most common and leading cause of anaemia in pregnancy both in developed and underdeveloped countries. The incidence of iron deficiency anaemia varies worldwide depending on differences in race, socioeconomic factors, nutritional status, health condition, and the frequency of parasitic illnesses. Untreated Iron deficiency has significant adverse foetal and maternal consequences. The management of iron deficiency anaemia includes education regarding dietary modification, specifically ways to enhance iron absorption and iron supplementation. Although oral supplementation is typically the mainstay of treatment, more severe cases of iron deficiency anaemia may require intravenous supplementation.

Perbandingan Konsumsi Buah Naga dan Sari Kacang Hijau terhadap Peningkatan Kadar Hb pada Ibu Hamil Anemia di Wilayah Puskesmas Mranggen II Kecamatan Mranggen Kabupaten Demak

ABSTRACT 
 Background: Anemia is still a complex health problem in Indonesian women. The most common cause of anemia in pregnancy is lack of nutrients in the body. Pharmacological treatment has side effects faster than non-pharmacological treatment. Natural products that are traditionally used as an additional intake in the prevention of anemia, for example there are dragon fruit, green beans, and so on. 
 Purpose: The purpose of this study was to determine the effectiveness comparison between consumption of dragon fruit and mung bean juice on increasing Hb levels in anemia pregnant women in the Mranggen II Public Health Center, Demak Regency. 
 This type of research is quantitative research with a research design using Two Group Pretest Posttest Design. The population in this study were pregnant women with anemia. Sampling using the entire population of as many as 40 respondents. Giving dragon fruit in the form of pieces shows 100% of the ingredients used and green beans are made by boiling to get the juice from the green beans. The research instrument was the Easy Touch Hb test as a measuring tool for Hb levels. Data analysis used Paired T-Test / T-dependent test. 
 Result: The results showed that the average hemoglobin level of pregnant women with anemia in the intervention group before being given Dragon Fruit had a Mean value of 10.241 g/dl, while after the intervention the Mean value became 11.125 g/dl. The Hb level in the control group before being given Mung Bean Extract had a Mean value of 10.825 g/dl while after being given Mung Bean Extract the Mean value became 11.266 g/dl. The results of the statistical test using the Independent T-Test between the two intervention groups and the control group showed p-values 0.539 which means there is no difference in the effectiveness of giving Dragon Fruit and Green Bean Extract to increase Hb levels in pregnant women with anemia. 
 Keywords: Dragon fruit, Green Beans, Increased Hb levels, pregnancy

Anemia Awareness, Causes, and Prevention among Pregnant Women at Asogbon Phc, Bariga, Lagos State, Nigeria

Anemia has been identified as a serious public health problem in both developed and developing countries, affecting around 2 billion people and accounting for threequarters of a million fatalities per year in Africa and Southeast Asia. Anemia in pregnancy is common, according to research from around the world. The purpose of this study was to determine the level of awareness, causes, and prevention of anemia in pregnancy among pregnant mothers attending Asogbon PHC Bariga in Lagos State, Nigeria. A well-structured questionnaire was used for data collection. The respondents were given a questionnaire. One hundred and nine (109) questionnaires were distributed, collected, and analyzed by respondents. The study's data was examined and processed with the Statistical Package for Social Science (SPSS) V21. To assess participant characteristics and offer responses to the study's research questions, descriptive analysis, frequency, average, and percentage were employed. The study discovered that knowledge about anemia signs, vulnerability, food, and prenatal visits was good, but information about causes and perceived effects of anemia was inadequate. According to the findings, the most common known cause of the condition is a poor diet, followed by malaria, worm infestations, and other factors. Despite widespread recognition that poor diet is the leading cause of anemia in pregnancy, there is little information about food sources that can assist in combating the disease. Also, less than half of those who profess knowledge of anemia-fighting foods eat them throughout pregnancy. The study found that the pregnant women were of reproductive age and had completed secondary and higher secondary school. The study revealed that while there was good awareness and prevention of anemia in pregnancy, To obtain a better feto-maternal outcome in pregnancy, there is a need to raise awareness about anemia in pregnancy and implement effective health education programs on anemia prevention.

Iron deficiency anemia in pregnancy: evaluation and management.

Anemia is a condition in which the number of red blood cells (RBC) is insufficient to meet the body's physiological needs for oxygen transport. A limiting factor for the erythrocyte mass increase is iron deficiency, which can also have a negative impact on the pregnancy's prognosis. The most frequent pathogenic cause of anemia in pregnancy is iron deficiency anemia (IDA). Biochemical tests such as serum iron concentration, total iron binding capacity (TIBC), transferrin concentration, and ferritin concentration are decreased in iron deficiency anemia. In clinical practice, iron deficiency is defined as low serum ferritin or a decreased percentage of transferrin saturation by iron. Usually, the diagnosis begins with the determination of serum ferritin. Although iron supplementation for iron deficiency is advised as soon as the condition has been diagnosed, prophylactic iron delivery is still under discussion. In patients for whom oral iron is ineffective or contraindicated, intravenous iron can be used to restore lost iron.

Prevalence of Severe Anemia among Pregnant Females and Factors Associated With Anemia in Pregnancy

Background: According to World health organization anemia is most common among females during pregnancy and child birth. Maternal and fetal morbidity and mortality is high due to anemia in pregnancy as it is a contributing factor in poor pregnancy outcome. It is the main cause of maternal death, almost 29% of women die due to anemia in pregnancy. Half of the maternal mortality causes are related to anemia in pregnancy either directly or indirectly. What so ever is the cause of anemia in pregnancy, its management is important for mother and child health. The consequences of anemia have serious health implications especially among pregnant females. Methodology: The cross-sectional study was conducted to find prevalence of anemia during first, second and third trimester of pregnancy and factors related to cause of anemia. A total of 340 pregnant females of government and private hospitals of Lahore city during the period from February 2017 to August 2018 were included in study after sample size calculation through convenient sampling. Sociodemographic, economic status, education level, number of children born to females and gestational period were the factors that were studied among anemic pregnant females. Data analysis was done and frequencies of continuous variables and descriptive analysis for categorical variables were determined. Prevalence of anemia was determined by multinomial logistic regression. Results: Our study showed females were with mean age 27.9 (±SD=5.4) and in age group 31-39 years (53.8%) were more anemic during pregnancy as compared to females <30 years of age. Most of the females (67.1%) were housewives and had primary level of education (49.1%). Among these females (30%) were with mild anemia, (53.5%) were with moderate anemia and (16.5%) were with severe anemia. The mean hemoglobin level was 9.8g/dl (SD=±1.6). Among pregnant females 152(45%) were anemic during third trimester of pregnancy. Result showed 167(48.8%) females were anemic having children > 3. Sociodemographic factors, education level, number of children born to female, economic status all were significantly associated with moderate anemia during pregnancy (p=0.00). Conclusion: Our study showed that although the prevalence of anemia is more among pregnant females but the severe anemia was less. So, it is a preventable health problem which can be controlled by different public health approaches to reduce the burden of disease on the health system. The strategies to control anemia in reproductive age women is important to prevent it among pregnant women. the early diagnosis and immediate correction of anemia is important to reduce the complications of pregnancy and its poor outcome. Early identification of factors is significantly important in managing the problem. Keywords: anemia, pregnancy, prevalence of anemia, gestational period.

Relationship Between Diet and Physical Activity with the Event of Anemia in Pregnant Women

The prevalence of anemia in pregnant women is 41.8 % . The causes of anemia in pregnancy include gravida, age, parity, education level, economic status and compliance with Fe tablet consumption, diet and physical activity. The purpose of this study was to determine the relationship between diet and physical activity with the incidence of anemia in pregnant women at Batunadua Health Center, Padangsidimpuan City in 2021 . The type of research is quantitative research with a cross sectional approach study . The population in this study were all pregnant women at Batunadua Health Center Padangsidimpuan City as many as 229 people. The sample in this study were 70 pregnant women at Batunadua Public Health Center, Padangsidimpuan City using random sampling method . The analysis used is Chi Square and Kolmogorov-Smirnov test . The results of this study indicate that there is a relationship between diet ( p=0.000) , and physical activity ( p=0.000) with the incidence of anemia in pregnant women. The conclusion is that diet and physical activity have a relationship with the incidence of anemia in pregnant women. Suggestions for pregnant women to increase antenatal care visits and find out about the incidence of anemia in pregnancy.

SKRINING ANEMIA SEBAGAI UPAYA PENINGKATAN KESEHATAN IBU HAMIL DI PRAKTIK MANDIRI BIDAN TANJUNG DELITUA

Iron deficiency is the most common cause of anemia in pregnancy. Complications that can occur from anemia in pregnant women are postpartum hemorrhage, low birth weight babies, premature birth and impaired fetal growth and development. Iron tablets are given once a day for 90 days during pregnancy. The survey at the Tanjung Clinic District Deli Tua that every pregnant woman is given antenatal care, education about the health condition of the mother and fetus and the administration of iron tablets, however monitoring of maternal health conditions through checking hemoglobin must still be carried out to ensure the effectiveness of iron tablets given to pregnant women. For this reason, PkM is carried out as a screening for anemia in pregnancy. This community service was carried out at PMB Tanjung Deli Tua in the form of physical examinations for pregnant women, checking hemoglobin levels with an easy touch device, giving iron tablets and providing education about the benefits and how to consume iron tablets correctly. The results obtained were that the majority of LiLA of pregnant women were 23.5 cm (95.4%) and the majority of pregnant women were secondary (52.2%). Then it was found out of 46 pregnant women who were examined 1 person (2%) had anemia. Through this PkM activity, it is necessary to collaborate with the nearest puskesmas to provide additional food for pregnant women who experience anemia and KEK.

LITERATURE REVIEW: DAMPAK ANEMIA DEFISIENSI BESI PADA IBU HAMIL

In general, the most common cause of anaemia in pregnancy is iron deficiency, which arises from maternal-fetal iron transfer, which is often exacerbated by a decrease in maternal iron stores. According to the World Health Organization (WHO), pregnancy anaemia is a global health problem that affects almost half of pregnant women. The purpose of this study was to conduct a journal review of explanatory and experimental articles published in the last 5 years starting in 2016 on deficiency anaemia in pregnancy. The research method is carried out by literature study using an electronic reference library through Medline, PubMed, NCBI, Science Direct and Proquest by investigating the impact of anaemia in pregnant women. The results literature from research in various developing and developed countries show that there is an impact that occurs when the mother had anaemia during pregnancy, namely prematurity, low birth weight, postpartum hemorrhage, maternal mortality, cesarean delivery and mental development of children. The conclusion is that there are several effects of anaemia in pregnant women, which are prematurity, low birth weight, postpartum hemorrhage, maternal mortality, cesarean delivery and children's mental development.

The Effect of Moringa Oleifera on Hemoglobin Level in Pregnancy

Anemia is a form of the body's compensation mechanism for decreasing hemoglobin levels. Anemia in pregnancy is a condition in which hemoglobin is below normal, which is below 11 g/dl. The most common cause of anemia in pregnancy is iron deficiency. Moringa leaves are one type of food that is rich in iron which can overcome anemia. The purpose of the study was to determine the effect of giving Moringa leaf soup on hemoglobin levels of pregnant women in the third trimester at the Oepoi Health Center, Kupang City in 2021. Quasy Experimental research design with a two group pre-test and post-test design. The study population was all pregnant women. The sampling technique is purposive sampling. The sample was 32 pregnant women. Statistical test using t-test. The location of this research was carried out at the Oepoi Health Center, Kupang City from July to August 2021. The research instrument was observation sheet and Hb measuring instrument. The results showed that the average hemoglobin of pregnant women before the intervention in the experimental group was 9.813 g/dl with a standard deviation of 0.57. The hemoglobin level of pregnant women after being given Moringa leaf soup in the experimental group was 11.494 g/dl with a standard deviation of 1.24. The average hemoglobin in pregnant women before intervention in the control group was 9.825 g/dl with a standard deviation of 0.61. The average hemoglobin in pregnant women after the intervention in the control group was 9.675 g/dl with a standard deviation of 1.28. Analysis using the t-test obtained a significance value of 0.000 <0.05. It can be concluded that there was a significant effect between giving Moringa leaf soup on hemoglobin levels in TM III pregnant women. It is hoped that in addition to consuming Fe tablets, it is also recommended to consume foods high in iron such as Moringa leaves to increase hemoglobin in pregnant women.

“PREVALENCE OF BETA-THALASSEMIA TRAIT IN PREGNANT WOMEN ATTENDING ANTENATAL CLINIC”

INTRODUCTION- Iron deficiency anemia and thalassemia syndromes,especially beta thalassemia trait (BTT),are the two most commonly ccuring microcytic hypochromic anemias highly prevalent in countries like India. Iron deficiency anemia is the first most common cause of anemia in pregnancy,beta thalassemia trait is the second most frequent cause of anemia of pregnancy. Patients with thalassemia trait shows an increased incidence of anemia during the second trimester of pregnancy. Beta Thalassemia Trait (BTT) patients are usually asymptomatic and ignorant of their carrier state unless diagnosed by testing. Screening for thalassemia can be done by measuring HbA2 levels MATERIAL AND METHOD- This is a retrospective study. The data were collected from a clinic and associated st pathology in Shivpuri and a private maternity hospital in Gwalior from 1 January 2019 to 30 June 2021.94 patients were included in the study.All pregnant women between the age of 18-45 years and at any gestational age with hemoglobin level <10g/dL and microcytic hypochromic anemia (report of CBC) were included in the study. High-Performance Liquid Chromatography (HPLC) and serum ferritin report were collected. RESULTS- In our study the most common age group in which the anemia was found between 19-35 years (80.85%).Most of the patients were primigravida (44.68%),between 26-37 wks of gestational age (82.97%),from a rural area (70.21%). Only 2 patients had a family history (2.12%) of beta-thalassemia and 6 patients had a history (6.38%) of blood transfusion. In our study moderate anemia was found in 55.31% of cases followed by mild anemia 25.53% and severe anemia 19.14%. In our study iron deficiency anemia was found in 87.23% only minor Beta-thalassemia was found to be 4.25%, of the patient,and the coexistence of iron deficiency anemia and beta-thalassemia in pregnant women is 8.51%. In our study total of 12 patients (4 cases of only minor beta-thalassemia and 8 cases of minor beta-thalassemia associated with IDA) The prevalence rate of beta-thalassemia in our study was 7.8%. CONCLUSION- the recommendation is to diagnose beta-thalassemia in pregnant patients is essential to give proper treatment.The screening of pregnant patients prevents unnecessary parental iron therapy and iron overload in case of anemia.further studies are needed in this field and less expensive and accurate methods should come in place.

Iron Deficiency Anemia in Pregnancy.

Anemia is defined as a low red blood cell count, a low hematocrit, or a low hemoglobin concentration. In pregnancy, a hemoglobin concentration of less than 11.0 g/dL in the first trimester and less than 10.5 or 11.0 g/dL in the second or third trimester (depending on the guideline used) is considered anemia. Anemia is the most common hematologic abnormality in pregnancy. Maternal anemia is associated with adverse fetal, neonatal and childhood outcomes, but causality is not established. Maternal anemia increases the likelihood of transfusion at delivery. Besides hemodilution, iron deficiency is the most common cause of anemia in pregnancy. The American College of Obstetricians and Gynecologists recommends screening for anemia with a complete blood count in the first trimester and again at 24 0/7 to 28 6/7 weeks of gestation. Mild anemia, with a hemoglobin of 10.0 g/dL or higher and a mildly low or normal mean corpuscular volume (MCV) is likely iron deficiency anemia. A trial of oral iron can be both diagnostic and therapeutic. Mild anemia with a very low MCV, macrocytic anemia, moderate anemia (hemoglobin 7.0-9.9 g/dL) or severe anemia (hemoglobin 4.0-6.9 g/dL) requires further investigation. Once a diagnosis of iron deficiency anemia is confirmed, first-line treatment is oral iron. New evidence suggests that intermittent dosing is as effective as daily or twice-daily dosing with fewer side effects. For patients with iron deficiency anemia who cannot tolerate, cannot absorb, or do not respond to oral iron, intravenous iron is preferred. With contemporary formulations, allergic reactions are rare.

Anemia in Pregnancy: ACOG Practice Bulletin, Number 233.

Anemia, the most common hematologic abnormality, is a reduction in the concentration of erythrocytes or hemoglobin in blood. The two most common causes of anemia in pregnancy and the puerperium are iron deficiency and acute blood loss. Iron requirements increase during pregnancy, and a failure to maintain sufficient levels of iron may result in adverse maternal-fetal consequences. The purpose of this document is to provide a brief overview of the causes of anemia in pregnancy, review iron requirements, and provide recommendations for screening and clinical management of anemia during pregnancy.

Hematologic Findings in Pregnancy: A Guide for the Internist.

Hematologic changes in pregnancy are common and can potentially lead to maternal and fetal morbidity. Here, we present various hematologic manifestations seen in pregnant women. Iron deficiency anemia (IDA) is the most common cause of anemia in pregnancy. Physiologically, the state of pregnancy results in increased iron demand. Iron deficiency is important to diagnose and treat early for better maternal and fetal outcomes. An algorithmic approach is used for the repletion of iron storage, starting with oral elemental iron daily and escalating to intravenous iron if necessary. Folate and cobalamin are necessary elements for deoxyribonucleic acid (DNA) synthesis, fetal growth, and maternal tissue development, and deficiency in these elements can be a cause for anemia in pregnancy. Thrombocytopenia is currently the second most common hematologic condition in pregnancy after anemia. There is a wide range of etiology for thrombocytopenia in pregnancy from benign to life-threatening causes that require prompt diagnosis and treatment. These conditions include gestational thrombocytopenia, thrombotic thrombocytopenic purpura, pregnancy-associated atypical hemolytic-uremic syndrome, and immune thrombocytopenia. Acquired bleeding disorders that can cause major complications in pregnancy include von Willebrand disease (vWD) and coagulation factor deficiencies. Women with vWD are at increased risk of pregnancy bleeding and postpartum hemorrhage. Pregnancy can also produce a physiologic hypercoagulable state, leading to life-threatening conditions like thromboembolism. Diagnosis, treatment options, and guidelines for the management of these conditions will be explored in this review.

PENGARUH KONSUMSI BAYAM HIJAU (Amaranthus sp) TERHADAP KADAR HB PADA IBU HAMIL DENGAN ANEMIA RINGAN DI WILAYAH KERJA PUSKESMAS KUNDUR BARAT

The Kundur Barat Health Centre apparently was noticed due to its high anemia incidence rate in 2017 which happened to 29.1% pregant women, this number is the second highest rate of anemia in Karimun occurred on mothers with hemoglobin (Hb) level of 9 g/dl at their first visit. The study aims to determine the impact of green spinach (Amaranthus sp) consumption on the average escalation of Hb levels on pregnant mothers with light anemia syndrome at Kundur Barat Health Centre of Karimun conducted from March to July 2018. Anemia in pregnancy happens as a condition of the mothers with hemoglobin below 11g/dl . The most common cause of anemia in pregnancy is iron deficiency which possibly triggers pregnant women to get a miscarriage, premature birth, bleeding before and during childbirth, and in severe anemia, it can cause maternal and infant death. One alternative to meet iron requirements is to routinely consume food with high iron (Fe), for instance spinach. This research is a quantitative research with quasy experiment of one group pretest and posttest research design to 34 respondents. The result shows the pretest mean score = 9.65 and posttest mean score = 12.48. On the other hand, the Paired-Sample T-Test confirms a significant difference on before and after consumption of green spinach (Amaranthus sp) of mean score = 2.83 with p value 0.05). Lastly, it is hoped that pregnant women to consume green spinach (Amarantus sp) as an alternative to increase their Hb levels.

THE EFFECTIVENESS OF COUNSELING THROUGH AUDIO VISUAL MEDIA USING ANIMATION VIDEO ON COMPLIANCE OF IRON TABLETS (FE) CONSUMPTION IN PREGNANT WOMEN AT WORKING AREA OF TANJUNG MORAWA COMMUNITY HEALTH CENTER IN 2020

The results of Basic Health Research (Riskesdas) issued by the Health Research and Development Agency (Baritbankes) of the Indonesian Ministry of Health in 2018 stated that the prevalence of anemia in pregnant women in Indonesia was 48.9%. In North Sumatra, blood tests were carried out on pregnant women from 9,377 pregnant women in three cities, namely Medan, Pematang Siantar and Kisaran. 33% of them had anemia. One of the causes of anemia in pregnancy is iron deficiency.
 The type of research used was pre-experiment with One Group Pretest-Posttest Design. In this study, using purposive sampling technique, namely 34 pregnant women.
 Adherence is the level of patients carrying out the treatment and behavior suggested by their doctor or by others. Meanwhile, the compliance with taking blood-supplemented tablets is a behavior where pregnant women support the iron supplementation program carried out by the government to prevent anemia in pregnant women.
 Based on the results of the research discussion entitled "Effectiveness of Extension through Audio Visual Media Using Animation Videos on Compliance with the Consumption of Iron (Fe) Tablets in Pregnant Women in the Work Area of ??the Tanjung Morawa community Health Center in 2020, it can be concluded that the compliance of respondents before being given counseling was the majority as obedient as 22 respondents ( 35.3%) and the compliance of respondents after being given counseling was the majority obedient as many as 29 respondents (85.3%), and the effectiveness of counseling through audio-visual media using animation videos on compliance with consuming iron tablets (Fe) in pregnant women in the work area of ?? Tanjung Morawa community health center in 2020 after being given counseling with the results of the T test paired sample T-test, it was obtained that sig 2 tailed was 0.000 (p value) <0.05. And it is hoped that the next researchers will develop this research using other media