Maternal Anemia
Vincenzo Berghella in Maternal-Fetal Evidence Based Guidelines, 2022
Risk factors for iron deficiency or iron deficiency anemia include diet poor in iron-rich food, a diet poor in iron absorption enhancers (vitamin C rich foods), a diet rich in foods that diminish iron absorption (dairy, soy products, coffee, spinach), pica (eating nonfood substances such as clay), gastrointestinal compromise affecting absorption (e.g., celiac disease, Crohn's disease, bariatric surgery), short pregnancy interval, parity ≥2, multiple gestation, low socioeconomic status and history of blood loss (heavy menses, postpartum hemorrhage). Though iron deficiency anemia from ongoing blood loss from the gastrointestinal system is less common in women of reproductive age, when iron deficiency is recognized during pregnancy, all possible causes should be considered.
The Patient with Anemia and Iron Deficiency
Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler in Heart Failure, 2023
In routine clinical practice, anemia is diagnosed using hemoglobin or hematocrit levels as surrogate markers for a reduced red cell mass, which is the strict definition of anemia. The most commonly used definition for anemia is a hemoglobin concentration <12 g/dL (7.5 mmol/L) for women and <13 g/dL (8.1 mmol/L) for men.29 A distinction should be made between “true” anemia (i.e., reduced hemoglobin and erythrocyte count) and pseudo-anemia caused by fluid overload, leading to hemodilution (i.e., reduced hemoglobin with normal erythrocyte count).10,30,31 Therefore, hemoglobin levels should ideally be measured when the patient is in a euvolemic state. In patients with acute decompensated HF, the absolute change in hemoglobin during intravenous diuretic therapy—indicating hemoconcentration—is an independent predictor of mortality.1 Other hematological parameters, such as mean corpuscular volume (MCV), red cell distribution width, and reticulocyte count may be normal in anemic patients. In a large, observational cohort of chronic HF patients, MCV was often within the normal range and not significantly associated with either vitamin B12 or folate levels. Therefore, MCV should be used cautiously in the differential diagnosis of anemia in chronic HF patients.6
Restricted rule-outs
Caroline J Rodgers, Richard Harrington in Helping Hands: An Introduction to Diagnostic Strategy and Clinical Reasoning, 2019
The following features may point towards a potential underlying haematological malignancy: Weight loss.Recurrent infections.Night sweats.Fever.Lymphadenopathy.Bone pain.Symptoms of anaemia (e.g. breathlessness, fatigue).
The clinical implications and importance of anemia in older women
Published in Acta Clinica Belgica, 2022
Osman Kara, Lee Smith, Semen Gokce Tan, Pinar Soysal
The prevalence of anemia ranges from 2.9% to 61% in older men and 3.3% to 41% in older women [5]. Factors that contribute to the variation in the prevalence include comorbid diseases, regions where individuals reside, hospitalization status, and nursing home residence status [5]. For patients, anemia may cause serious economic and socio-cultural problems, such as withdrawal from functional-social life and depressive symptoms [6]. Anemia can present with relatively mild symptoms, such as weakness, fatigue, lack of attention, palpitations, dizziness, and dyspnea [3,5]. However, it may also present with more severe symptoms including, for example, falls, cognitive dysfunction, aggravation of congestive heart failure, and also mortality [3,5,6]. Importantly, as the severity of anemia increases, the severity of the symptoms are also more likely to increase [7].
Iron deficiency and cyanotic breath-holding spells: The effectiveness of iron therapy
Published in Pediatric Hematology and Oncology, 2018
Sherifa A. Hamed, Eman Fathalla Gad, Tahra Kamel Sherif
All children (patients and controls) were subjected to (a) medical and neurological histories and examinations. Histories include history of abnormal bleeding, blood transfusion and excessive surgery. Symptoms of Iron deficiency anemia included the following: excessive fatigue, dizziness, headache, depression, sore tongue, increased sensitivity to cold and shortness of breath, (b) electrocardiography or ECG (12 leads) and echocardiography, (c) EEG and (d) laboratory investigations: All participants underwent complete blood count (CBC), kidney and liver function tests. Serum iron was measured using colorimetric chromazuol B,22 serum ferritin was measured using electrochemiluminescence using elecsys and cobas (2010) immunoassay analyzers. Iron deficiency is defined as serum ferritin level less than 12 ng/ml. Iron deficiency anemia is defined by presence of iron deficiency and hemoglobin level <10.5 g/dl.23 Patients with iron deficiency or Iron deficiency anemia were treated with iron (ferrous sulfate in a dose of 6 mg/kg/day) for 3 months and then 3 mg/kg/day for another 3 months. Follow-up was done monthly by the treating physician(s).
Health disparities and chronic disease associated with anemia in free clinics: A retrospective study of uninsured patients in Tampa Bay
Published in Postgraduate Medicine, 2019
Abu-Sayeef Mirza, Liwei Chen, Sean Amirzadeh, Saagar Majethia, Jeffrey Joppen, Sabbir Mirza, Rahul Mhaskar, Michael Jaglal, Noman Ashraf
As expected, most patient with anemia in our study were women. On a global scale, anemia in women is usually due to iron deficiency secondary to gynecological conditions and increased demand during pregnancy [16]. However, poor nutritional knowledge and limited access to iron absorption enhancing foods in some communities of low socioeconomic status increases the morbidity of anemia among women [17]. Although we did not collect information about pregnancy, such information may be useful as other studies have shown that prenatal replacement with daily iron may reduce morbidity among pregnant women [7]. Nevertheless, most women requiring prenatal care usually utilize government funded support organizations. Organized and directed education has been shown to increase adherence to iron replacement and prevent long term effects of untreated anemia [5,18]. Such a strategy may be particularly useful in a resource limited setting such as our free clinics.
Related Knowledge Centers
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