Severe Anaemia In Pregnancy Research Articles

Severe Anemia in Pregnancy: Risks and Interventions – A Review

Severe anemia during pregnancy is a major global health concern, particularly in low- and middle-income countries, where it contributes significantly to maternal and fetal morbidity and mortality. Characterized by hemoglobin levels below 7 g/dL, severe anemia is often driven by nutritional deficiencies, infectious diseases, and genetic disorders, with iron deficiency being the most prevalent cause. This condition exacerbates pregnancy-related risks, increasing the likelihood of complications such as preeclampsia, postpartum hemorrhage, and intrauterine growth restriction. Left unaddressed, severe anemia impairs oxygen delivery to maternal and fetal tissues, adversely impacting immune function and overall health. Effective management of severe anemia in pregnancy relies on a combination of preventative and therapeutic interventions. Iron and folic acid supplementation remain foundational in anemia prevention, with intravenous iron and blood transfusions employed in critical cases. Nutritional education, emphasizing iron-rich diets and vitamin C intake, complements these clinical approaches, while treating underlying infections like malaria and hookworm is essential for reducing anemia incidence in endemic regions. Community-based health programs promoting early prenatal care and routine anemia screening play a crucial role in improving intervention success and patient adherence.

Fetomaternal Outcomes of Severe Anemia in Pregnancy: A Prospective Observational Study.

Introduction Anemia during pregnancy can lead to poor pregnancy outcomes, increasing maternal, fetal, and neonatal morbidity and mortality. Timely detection and management can lead to improved pregnancy outcomes. Objective To study various fetomaternal outcomes in severe anemia during pregnancy. Methods It is a prospective observational study conducted on 102 pregnant females, who presented with severe anemia (hemoglobin (Hb) < 7 gm/dL) between February 2020 and March 2021. Results In this study, 50% of patients presented before term (<37 weeks of gestation). Patients predominantly belonged to the rural population (n = 71, or 69.61%), the majority were multigravidas (81.37%), and 56.86% belonged to the upper-lower socioeconomic class. The mean age at presentation was 26.55 ± 4.99 years. Among maternal outcomes, abruption was seen in 7.84% of patients, post-partum hemorrhage (PPH) in 14.71%, sepsis in 3.92%, prolonged hospitalization in 48.04%, intensive care unit (ICU) admission in 4.90%, and maternal mortality in one patient. Additionally, 82.35% of patients went into spontaneous labor, and 76.47% of patients delivered vaginally. Among fetal and neonatal outcomes, 50% of neonates were premature, 62.75% were low birth weight (LBW), 42.16% were small for gestational age (SGA), and 22.55% of neonates were admitted to the neonatal ICU, of which two neonates expired. Stillbirth was noted in six (5.88%) babies. When the studied population was divided on the basis of the severity of anemia into two groups (Group A: very severe anemia with Hb < 4 gm/dL and Group B: severe anemia with Hb ≥ 4 gm/dL but <7 gm/dL), most of the outcomes were much worse for group A, with a statistically significant difference. Conclusion Not only can very severe anemia (Hb < 4 gm/dL), but also severe anemia (Hb ≥ 4 gm/dL but <7 gm/dL), adversely affect both maternal and fetal outcomes if not diagnosed and optimized on time.

Using an experience-based co-design approach to develop strategies for implementing an intravenous iron intervention to treat moderate and severe anemia in pregnancy in Malawi

BackgroundIn low- and middle-income countries, women experiencing anemia during pregnancy are recommended to take 30 mg to 60 mg of oral iron daily throughout pregnancy. However, oral iron tablets are often poorly tolerated and slow in correcting anemia, resulting in low adherence, prolonged anemia, and increased risk of adverse maternal and fetal outcomes. An alternative to oral iron is intravenous (IV) iron, commonly used in high-income countries to restore the body’s iron stores rapidly. A randomized controlled trial was conducted to investigate the effectiveness and safety of IV iron compared to standard-of-care oral iron supplementation for pregnant women with moderate and severe anemia in the third trimester in Malawi (REVAMP-TT). Using an experience-based co-design approach, our study aimed to identify barriers and facilitators to IV iron use to treat anemia in pregnancy in the primary healthcare system of Malawi, and develop mitigating strategies for the successful implementation of REVAMP-TT.MethodologyThe co-design process involved two phases: i) We conducted an information-gathering exercise to identify barriers and facilitators to IV iron use to treat anemia in pregnancy in the primary healthcare system of Malawi. We interviewed key informants (n = 53) including the policymakers, government partners, healthcare managers, and healthcare providers. We also gathered previous research findings from a formative qualitative study on the perceptions and experiences of IV iron treatment for pregnant women experiencing anemia in Malawi (n = 29). ii) We conducted two co-design workshops with end-users (n = 20) and healthcare providers (n = 20) to confirm and identify the key barriers and facilitators and developed mitigating strategies to inform the successful implementation of the REVAMP-TT trial. We mapped the emerging barriers to the Consolidated Framework for Implementation Research 2.0 (CFIR 2.0) and matched the mitigating strategies to the corresponding Expert Recommendations for Implementing Change (ERIC) compilation.ResultsThe following were identified as key barriers to IV iron use to treat anemia in pregnancy in the primary healthcare system of Malawi: the cost of IV iron, the lack of available resources and knowledge, local attitudes including myths and misconceptions about IV iron and keeping pregnancy a secret, local conditions, the lack of political will and buy-in from high-level leaders, the lack of capability of healthcare providers to deliver IV iron, and the lack of male involvement to support pregnant women's access to antenatal care. The proposed strategies to mitigate the barriers for the successful implementation of the REVAMP TT trial included providing financial strategy, developing stakeholder relationships, training and educating stakeholders, supporting clinicians, and engaging end-users.ConclusionThe use of the experience-based co-design approach in our study provided a valuable method to expose the potential barriers and facilitators to IV iron use and develop mitigating strategies to successfully implement the REVAMP-TT trial. Engaging both the key informants and end users promoted ownership and consensus among stakeholders and ensured a collaborative environment for sharing deeply rooted real-world experiences and insights. Not only do these findings address the needs of this study, but they also, lay a groundwork for the possible integration of IV iron into routine care in Malawi and provide knowledge for policymakers to make informed decisions on the management of anemia in the primary healthcare systems of Malawi.

Outcome of Severe Anemia in Pregnancy; Experience at a Tertiary Care Hospital

Objective: The study was aimed at observing demographic diversity among pregnant women admitted to the labour room with Hemoglobin of less than 7gm/dl. It also observed perinatal and maternal outcomes and their associated complications. Study Design: Retrospective observational study. Settings: Gynae Unit I, Jinnah Hospital, Lahore Pakistan. Duration: 1st January 2022 to 30th June 2022. Methods: It is a retrospective observational study carried out in Gynae Unit I, Jinnah Hospital Lahore in between 1st January 2022 to 30th June 2022. All Patients presenting with Hemoglobin less than 7gm/dl and admitted in the Labour room were included in the study, and followed until delivery. A predesigned performa was filled for each of the 63 patients after their consent. Results: During the study period, 2130 deliveries were carried out in the labour room, out of which 63 patients had a recorded level of Hemoglobin below 7gm/dl. The prevalence of severe anemia in our study was 2.9%. Most patients (51) were in the age group 20-35 years. Majority of the patients (45) were un-booked while only 18 were booked patients. 40 patients were in the gestational age group of 34-37 weeks. 30 were gravida 2-5, 25 of parity more than 5 and only 13 primigravida’s. 29 out of 63 patients had no complications while 34 had complications. Conclusion: Severe Anemia is a preventable cause, the focus needs to be on early and proper antenatal check-up’s, early diagnosis, and timely referral from rural and less equipped medical centres to better equipped hospitals.

Study of Prevalence of Severe Anemia in Pregnancy and the Associated Adverse Maternal and Fetal Outcomes

Study of Prevalence of Severe Anemia in Pregnancy and the Associated Adverse Maternal and Fetal Outcomes

Predictors of maternal and fetal outcome in severely anemic pregnant mothers: A sequential mixed methods study.

Severe anemia in pregnancy increases maternal and neonatal morbidity and mortality in the antenatal period. To find out the maternal and fetal outcomes in severely anemic pregnant women and explore the reason for the persistence of severe anemia in pregnant women. Sequential explanatory mixed method study (Quan-Qual) was conducted in the Government Women and Children Hospital for a period of 1 and half years. Most of the people were from rural backgrounds and belonging to low socioeconomic status have been registered. Quantitative data were collected from 125 severe anemic cases; a consecutive sampling technique was applied. In-depth interviews were conducted among purposively selected severe anemic patients (n = 15) who were vocal and willing to explore the reason for the persistence of anemia. The interviews were conducted till the point of saturation. Ethical principles were adhered throughout the study. Quantitative data were anlyzed using SPSS software. Manual content analysis was done for qualitative data. Among 125 severe anemic patients, 12.8% patients had preterm labour, about 23.2% had inadequate lactation, and 13.6% had a puerperal febrile illness. It was found 41.6% of neonates had respiratory distress and 33.6% had the refusal of feeds. When compared to vaginal delivery, women undergoing cesarean section have 3.2 times (95% confidence interval 1.39-7.32) higher odds of developing maternal complications. Nagelkerke's R2 value for the model was 11.1%. Five broad categories namely Family centric nature, Lack of awareness, Pill burden, Food Fads, and Myths related to iron intake emerged from the study. Complications can occur in mothers and neonates if anemia is not corrected in early trimester.

Intravenous Iron Therapy in Severe Anemia at 28-34 Weeks of Gestation and it’s Feto-Maternal Outcome- A Prospective Study from A Developing Country

Introduction: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy. Anemia results in poor pregnancy outcome and also affects fetal outcome. This study was undertaken to evaluate the response of intravenous iron given to pregnant women with severe IDA and their feto-maternal outcome.&#x0D; Methodology: A prospective study was conducted in the department of Obstetrics &amp; Gynaecology, at a tertiary care centre of Northern India. Fifty-two pregnant women with haemoglobin between 5-7 g% with diagnosed iron deficiency attending antenatal clinic were given intravenous iron complex Follow-up after 4 weeks was done and IDA specific blood profile was done at baseline and at follow-up. Feto-maternal outcomes were seen at delivery.&#x0D; Results: The mean age of study population was 25.5 ± 3.96 yrs. Improvement at 4 week follow-up from baseline in hemoglobin (p value-0.001) and iron profiles (S. Iron, Total Iron Binding Capacity (TIBC), S. Ferritin) (p value -0.0001) were highly significant. On comparing the Hb levels at delivery after intravenous infusion at 28-34 weeks gestation, 17 patients were still below 8 gm%, whereas 35 were above 8 gm%. Distribution of IUGR, preterm labor and blood transfusion in postpartum period were statistically significant amongst both group (p value&lt;0.05). Fetal outcomes were also evaluated amongst the 2 groups. Distribution of Preterm birth, birth weight and NICU admission was also statistically significant (p value&lt;0.05).&#x0D; Conclusion: The intravascular iron therapy definitely has a rapid increase in haemoglobin which can prevent the complications due to severe anaemia in pregnancy and blood transfusion can also be prevented, but iron stores are not replenished to the optimum level, so there is a need to give replacement therapy (by oral route) post transfusion for long term benefits. The rise of hemoglobin affects feto-maternal outcomes even in the last trimester.contrast agents. This is a first case report of AHCM portrayed by this ingenious technology.&#x0D; Keywords: AMCH, IUGR, TIBC

Maternal anemia is associated with adverse maternal and neonatal outcomes in Mbarara, Uganda

Purpose Maternal anemia is a significant risk factor for maternal morbidity and mortality, increasing risk of preterm birth, intrauterine growth restriction, stillbirth, and death. Moderate and severe anemia in pregnancy is defined as hemoglobin (Hb) <10 g/dl and Hb < 7 g/dl, respectively. We aimed to characterize the association of maternal anemia with maternal, neonatal, and placental outcomes in a resource-limited setting. Methods Data were collected from a prospective cohort of 352 pregnant women at a tertiary academic Ugandan hospital. One hundred and seventy-six (50%) of women were living with HIV. Hemoglobin was measured in labor, and placentas were collected postpartum. Maternal outcomes included mode of delivery, hemorrhage, blood transfusion, intensive care unit admission, and maternal mortality. Neonatal outcomes included gestational age at delivery, birthweight, stillbirth, and neonatal mortality. Placental descriptors included weight and thickness. Categorical variables were analyzed using Chi-squared and Fisher’s exact tests. Results Hemoglobin < 10 g/dl, was present in 17/352 (5%) of women. Significantly more women with moderate or severe anemia were HIV-infected: 14/17 (82%) versus 162/335 (48%) (p = .006). Blood transfusions (2/17, 12% versus 5/335, 2%, p = .04) and neonatal deaths (2/17, 12% versus 9/335, 3%, p = .01) were more common in the anemia group. Placental thickness was lower in the anemia group (1.4 cm versus 1.7 cm, p = .04). Conclusions Moderate and severe anemia was associated with maternal HIV infection, maternal blood transfusion, neonatal death, and decreased placental thickness. The overall rate of moderate and severe anemia among this cohort was lower than previously reported.

A Case of Very Severe Anemia in Pregnancy Combined with Beta-Thalassemia Major and Pre-Eclampsia

OBJECTIVE: To investigate the clinical diagnosis, preventive antenatal screening and antenatal diagnosis, pregnancy management, timing and mode of delivery and postnatal management of β-thalassaemia in pregnancy combined. METHODS: Retrospective analysis of the medical history and treatment of a patient with β-thalassaemia in pregnancy combined with pregnancy outcome. RESULTS: The patient recovered well, had a normal temperature, the abdominal incision was removed at 7 d, the II/nail healed, the general obstetric condition was acceptable and she was discharged successfully. CONCLUSION: Anaemia is very common in pregnancy, but very severe anaemia in pregnancy is extremely rare and it is important to define the cause of anaemia. Thalassaemia is a group of inherited chronic haemolytic disorders caused by autosomal defects, which can be aggravated by pregnancy. Thalassaemia can be divided into α-, β-, γ-, δ-, δβ- and other categories, and for β-thalassaemia it can be divided into mild, moderate and severe, with both intermediate and severe patients presenting early with obvious anaemic symptoms and relying on long-term transfusion therapy. The majority of these patients die in childhood and are extremely rare in pregnancy. Thalassaemia in pregnancy can directly affect the outcome of pregnancy and cause many near and long-term complications in the newborn, and timely antenatal screening and prenatal diagnosis can detect the disease early. Active obstetric management and timing of pregnancy can also help to improve maternal and infant pregnancy outcomes.

Malaria Parasitemia and Anemia among Pregnant Women Attending General Hospital, Enugwu-Ukwu, Southeastern Nigeria

Women has been reported to be more susceptible to malaria parasites infection during pregnancy. The disease causes severe anemia in pregnancy sometimes resulting to maternal morbidity and mortality in many parts of the world including Nigeria. A study to determine malaria parasitaemia among pregnant women attending General hospital Enugwu-Ukwu, Anambra State, Nigeria, was conducted between July and December, 2019. The specific objectives were to determine the prevalence of malaria parasites and anemia among the pregnant women as well and the relationship between malaria and anemia. Two milliliters of venous blood were collected from 408 pregnant women during antenatal visits. Thick and thin blood films were made, stained with 10% Giemsa stain and examined under the microscope for malaria parasites. Hemoglobin (Hb) concentration was estimated using cyanmethemoglobin method. Hemoglobin concentration below 11.0g/dl was regarded as anemia in pregnancy. Of 408 blood samples collected, 112(27.5%) were positive for malaria parasites. The age group 15–20 years had the highest prevalence 8(40%) while the age group 36–40 years had the least 24(23.1%). The primigravidae had the highest malaria prevalence 72(36%), while the multigravidae had the least 40(19.2%). The pregnant women in first trimester had the highest malaria prevalence 48(50%), while those in third trimester had the least 24(16.7%). Malaria parasitaemia in relation to trimester was statistically significant (P&lt;0.05). A total of 248(60.7%) pregnant women had a Hb value less than 11g/dl. The multigravidae had the highest Hb 128(61.5%), while the primigravidae had the least 120(60%). Health education and proper administration of Intermittent Preventive Therapy (IPT) during pregnancy is recommended for malaria prevention and control in pregnancy.

A Hospital Based Study to Access the Usefulness of Using the Combination Regime of the Ferric Carboxy Maltose, Vitamin B12 and Folic Acid as a Treatment of Severe Anemia among Pregnant Women in a Rural Tribal Community of South Gujarat.

Anemia is most common morbidity in pregnancy and micronutrient deficiency is its most common cause in India. It is to assess the beneficiary effects as well as side effects of single parenteral administration of ferric carboxymaltose (FCM), Vitamin B12, and folic acid as treatment of severe anemia during pregnancy. This pre-post intervention study was done from April 2018 to March 2019 at a charitable hospital. 100 pregnant women were treated with one infusion of FCM (1000 mg), along with intramuscular Vitamin B12 (500 mcg) and folic acid (15 mg) followed by daily oral supplementation of iron (100 mg) up to delivery. Compared to baseline, absolute increase in hemoglobin was 2.9 g/dl (P < 0.001) and 5.4 g/dl (P < 0.001) after 6 weeks of infusion and at delivery, respectively. 63.9% of women turned nonanemic and none had severe anemia at delivery. No serious side effect was reported and none needed blood transfusion at any time during the study. FCM along with Vitamin B12 and folic acid might be considered for treating severe anemia in pregnancy in resource-poor settings.

An implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocol

BackgroundAntenatal iron supplementation is critical to maternal and child health; however, access and adherence to oral iron are inconsistent in many low- and middle-income countries (LMICs). Modern intravenous (IV) iron products have become available in high-income clinical settings and provide an opportunity to deliver high doses of iron in a single-short infusion during pregnancy. However, there is limited knowledge of the drivers and barriers for such an intervention to be effectively delivered and upscaled in LMICs. In this study protocol, we describe the implementation research programme to support an IV iron intervention in Malawi for pregnant women with moderate and severe anaemia.MethodsThe implementation research programme has three phases, each guided by implementation science conceptual frameworks. In Phase 1, we will conduct formative research (context assessment of the health system with key informant interviews) to determine how IV iron can be effectively introduced into routine antenatal care. We will use the findings to co-develop potential strategies with end-users and healthcare providers to improve intervention implementation. In Phase 2, we will disseminate the implementation strategies to support the uptake and delivery of the intervention in the study settings. In Phase 3, the intervention will be implemented, and we will conduct formative evaluation (interviews with end-users, healthcare providers, and analysis of health services data) to investigate the feasibility and acceptability of the intervention and strategies. We will also identify processes and contextual factors that facilitate or impede the delivery and uptake of IV iron.DiscussionIn LMICs, modern IV iron products present a novel opportunity to rapidly cure moderate and severe anaemia in pregnancy, thereby improving maternal and child health outcomes. This implementation research programme will provide guidance and recommendations on how best an IV iron intervention for pregnant women with anaemia can be implemented in an LMIC setting like Malawi. We will develop locally relevant and culturally appropriate implementation strategies by engaging with key stakeholders (pregnant women, healthcare providers, and policymakers) and identifying factors likely to facilitate successful implementation. The findings of this research can guide the implementation of an IV iron intervention in Malawi and other LMICs.

Severe Anemia during Pregnancy in the Maternity Ward of the Kalabancoro Reference Health Center

Introduction: The main objective was to determine the maternal and fetal consequences of severe anemia in pregnancy at the maternity ward of the Kalabancoro Reference Health Center. Methods: Our descriptive cross-sectional study with prospective data collection was conducted from January 1, 2019 to September 30, 2019 at the maternity ward of the Kalabancoro Health Center. Eligible patients were all consenting pregnant women presenting for prenatal consultation or in the delivery room in which the diagnosis of severe anemia was retained. The anemia was considered severe when the hemoglobin level was less than 7 g/dl and/or with clinical manifestations of decompensation of the anemia. Data were processed and analyzed by SPSS 12 software. Results: A total of 161 cases out of 2010 pregnant women were recruited and treated at the Kalabancoro Health Center, which represents a prevalence of 8% of severe anemia in pregnancy. The 14-19 year age group was the most representative, i.e. 52.2% of pregnant women, with extremes of 14 to 35 years and over. Malaria was the most predominant etiology with 31.05% followed by blood spoliation 25.47% and malaria plus malnutrition 14.29%. Prematurity represented 5% of cases. Maternal death was 1.9%. Low birth weight was 16.7% and stillbirths represented 3.7%. Conclusion: Severe anemia in pregnancy remains, through its complications, one of the most dreaded pathologies. Thus, a prospective analytical study is necessary to better study the causes of severe anemia in pregnancy.

Predictors of blood transfusion among patients admitted with early severe pre-eclampsia

Transfusion of packed red blood cells (pRBC) is an effective strategy for the management of severe anemia in pregnancy. Although rare, transfusion does incur risk and reactions can be severe. We sought to investigate rates of pRBC transfusion in patients with early (< 34 weeks), severe preeclampsia (sPREX) and to determine factors associated with transfusion in this population.

736Low Birth weight in new born, anaemia in pregnancy in Fluoride endemic areas of Rajasthan

Abstract Background Rajasthan has been documenting severe anaemia in pregnancy, resulting in low birth weight. Current study was planned to explore potential linkages between exposure to fluoride, anaemia in pregnancy and low birth weight in infant. Methods Antenatal mothers from one fluoride endemic district (FD) and one non-fluoride endemic district (NFD) of western Rajasthan were recruited and followed up till delivery. Data included socio-demographic, lifestyle, diet, medication history. Lab Investigations included Hb, Urinary Fluoride. Results Out of total 1401 women, mean age of women from FD were 23.87 (+ 3.8) yrs and from NFD were 25.53(+ 3.82) yrs. Mean fluoride values in the urine samples of pregnant females were found to be 2.06 (0.0 to 14.4 mg/L) in FD and 1.43 (0.00 to 12.7 mg/L) in NFD. Mean fluoride values in water samples were 0.72 (0.0 to 3.80 mg/L) in FD and 0.21 (0.0 to 2.69 mg/L) in NFD. Mean weight of newborn from FD were 2.92 (+ 0.47) yrs and from NFD were 2.94 (+ 0.56) kg. 22% Newborn in FD and 18% in NFD had low birth weight. Conclusions Infants born in Fluoride endemic area have lower birth weight as compared to non-Fluoride endemic area. Antenatal women in Fluoride endemic areas are more anaemic. Key messages Fluoride endemicity is an important factor to be considered while addressing Anaemia in pregnancy and Low Birth Weight Babies in Western Rajasthan, India.

Is IV iron sucrose a cost-effective option for treatment of severe anaemia in pregnancy as compared with oral iron?

Anaemia in pregnancy is a public health concern because it is strongly associated with maternal and perinatal morbidity and mortality. An open label randomized controlled trial (RCT) was conducted in India across four government medical colleges, comparing intravenous (IV) iron sucrose and oral iron for the treatment of anaemia in pregnancy. This RCT failed to demonstrate superiority of IV iron sucrose compared with oral iron therapy in reducing adverse clinical (maternal and foetal/neonatal) outcomes in moderate-to-severe anaemia in pregnancy. However, IV iron sucrose seemed to reduce the need for blood transfusion among women with severe anaemia. The study objective was to conduct a cost-effectiveness analysis of IV iron sucrose over oral therapy for treatment of severe anaemia in pregnancy, alongside the RCT, to inform policy. The outcome of interest in our study was a 'safe delivery' defined by the absence of composite maternal and foetal/neonatal adverse clinical outcomes. Incremental cost-effectiveness ratio (ICER) was calculated from a limited societal perspective. IV iron sucrose was found to be more costly but more effective than the oral therapy for treatment of severe anaemia. The ICER was calculated at INR 31951 (USD 445.2) per safe delivery. We considered a threshold of half the gross national income for decision-making. Considering this threshold of India (INR 57230, USD 797.4), IV iron-sucrose remained cost-effective in 67% of the iterations in the model. At the current ICER, for every 32 severely anaemic pregnant woman treated with IV iron sucrose one additional pregnant woman will have a safe delivery. Such analyses can complement the national strategy to support evidence-based action.

MISDIAGNOSED ADVANCED INTERSTITIAL PREGNANCY - A CASE REPORT

Interstitial pregnancy is a rare and dangerous form of ectopic pregnancy that can be mistaken for a normal intrauterine pregnancy on ultrasonography leading to catastrophic results. Gynecologist should be aware of the potential for mistaking an interstitial pregnancy for intrauterine pregnancy. We present a case of 14 weeks interstitial pregnancy misdiagnosed on abdominal ultrasonography as intrauterine pregnancy with ascites. She was treated as sub-acute intestinal obstruction with severe anemia in pregnancy for 2 days. The correct diagnosis was first made at emergency laparotomy which showed hemoperitoneum and rent involving the right superolateral end of the uterus, with fetus and placenta lying in pouch of Douglas. Wedge resection of the right superolateral end of uterus along with repair done. Lack of suspicion and lack of expertise are a common cause for missing this rare ectopic pregnancy.

A Study of Prevalence and Pathophysiology of Severe Anaemia in Pregnancy in a Tertiary Health Care Centre of Central India

A Study of Prevalence and Pathophysiology of Severe Anaemia in Pregnancy in a Tertiary Health Care Centre of Central India

A study on magnitude of anaemia and its socio-demographic correlates among pregnant women in Sagar city of Bundelkhand Region, Madhya Pradesh, India

Background: India is one of the countries with very high prevalence of anaemia in the world. Almost 58% of pregnant women in India are anaemic and it is estimated that anaemia is the underlying cause for 20-40% of maternal deaths in India. India contributes to about 80% of the maternal death due to anaemia in South Asia. First Anaemia reduces women’s energy and capacity for work and can therefore threatened household food security and income. Second, severe anaemia in pregnancy impairs oxygen delivery to foetus and interferes with normal intrauterine growth, resulting in intrauterine growth retardation, still birth, LBW and neonatal deaths. Therefore anaemia is a major contributor to poor pregnancy and birth outcomes in developing countries as it predisposes to premature delivery, increased perinatal mortality and increased risk of death during delivery and postpartum. Keeping this view in mind the study was carried out with the objectives to assess the magnitude and risk factors for anaemia among urban pregnant woman in Sagar City, Madhya Pradesh, India. Methods: A cross sectional study was conducted at the urban health training centre Chameli chauk, Sagar, MP,India from 1 st January to 30 th September 2014. A total 150 pregnant women were studied. Results: Overall prevalence of anaemia among pregnant women was found to be 74.7% of which maximum 44.7% were suffering from mild anaemia and 22.7% had moderate degree of aneamia whereas only 11 (7.3%) were severely anaemic. Religion, caste, educational attainment, socioeconomic status and parity come out to be important predictors of anaemia in pregnancy (P<0.05). Conclusions: In the present study prevalence of anaemia in pregnant women was found to be high specially among Hindus, Schedule caste, illiterates, low income group and Multiparous women, indicating very poor maternal and child health care in the region. So there is a need to intensify IEC activities to promote early antenatal check-up, dietary modification and utilization of family planning services in the region.

Intermittent oral iron supplementation during pregnancy.

Intermittent oral iron supplementation during pregnancy.