What is harmful low hemoglobin for pregnant women. Reduced hemoglobin during pregnancy: what is dangerous and how to increase it? Increased level - the other side of the coin

04.03.2021

A decrease in hemoglobin is one of the most common problems during pregnancy. This phenomenon is called anemia and is characterized by a decrease in the concentration of red blood cells in the blood. In layman's terms, there is not enough iron in the body.

Most women at the same time begin to fear for the health of the baby and want to quickly correct the situation.

Is this fear justified? Is anemia dangerous for the expectant mother and child? How can you raise low hemoglobin during pregnancy?

How does blood change during pregnancy?

With the onset of pregnancy, the body of the expectant mother begins to work with double strength, because it is necessary to provide the baby with nutrition and the full development of all systems.

A woman undergoes changes in the composition of the blood: it becomes more viscous, the volume of plasma increases, and the concentration of hemoglobin decreases due to the fact that the mother gives the child a lot of iron.

The norm of hemoglobin in expectant mothers is 110-130 g / liter. In cases where this figure is lower during pregnancy, iron deficiency anemia is diagnosed.

There is a mild degree of anemia during pregnancy (from 100 to 110 g / l), medium - from 70 to 100 g / l and severe - below 70 g / l.

Anemia of the 1st degree for a pregnant woman and a child is not dangerous, but you must definitely pay attention to your diet and correct the situation in natural ways;

The easiest way to increase hemoglobin is to adjust the diet and include iron-containing foods in the diet.

Note! From the 28th week of pregnancy, a natural decrease in hemoglobin occurs due to an increase in blood volume. The hemoglobin index can be 105 mg / l. If it falls below, then you need to adjust according to the principles described in the book on nutrition for pregnant women.

Causes of a decrease in hemoglobin during pregnancy

Anemia during pregnancy occurs more often in women who are predisposed to it, that is, they always (before pregnancy) had a low level of hemoglobin;
Multiple pregnancy: a woman's body is depleted faster, the "reserve" of iron should also be larger;
Inadequate nutrition. If there are not enough iron-rich foods in the diet of the expectant mother, then anemia may occur;
Severe toxicity. Due to vomiting and loss of appetite, a woman's body does not absorb important nutrients, including iron (read the article on the topic: Vomiting during pregnancy >>>;
Bleeding. Any blood loss leads to the fact that the level of hemoglobin becomes lower;
Acute, chronic, infectious diseases of internal organs;
Multiparous women develop anemia more often than those who are expecting their first child;
Small interval between pregnancies. If three years have not passed since the previous birth, then the woman's body has not yet had time to properly recover;
Taking certain medications;
Stress, lack of rest.

How does a decrease in hemoglobin feel?

Symptoms of anemia during pregnancy can include:

increased fatigue, drowsiness;
dizziness, headaches (current article: Headache during pregnancy >>>);
the appearance of noise in the ears;
dyspnea;
increased heart rate;
cold extremities;
pallor and dry skin;
hair and nails become brittle.

With a slight decrease in hemoglobin, no symptoms may be felt.

Why is low hemoglobin dangerous during pregnancy?

To assess the danger of the current situation, you need to take into account the degree of anemia. With a slight drop in hemoglobin (up to 100 g / liter), there is no threat to the baby and mother. But with more serious deviations, the degree of danger increases and there is a need for urgent action.

The consequences of low hemoglobin during pregnancy for the child and mother:

a severe lack of iron can lead to oxygen starvation of the fetus and a lack of useful substances;
there may be a threat of miscarriage;
late toxicosis (see article Preeclampsia during pregnancy >>>);
placental abruption;
premature birth;
weak generic activity;
bleeding during childbirth;
increased susceptibility of the baby to various infections after childbirth.

The possibility of such consequences is a good reason to carefully monitor the level of hemoglobin and treat anemia.

How to raise the level of hemoglobin?

There are several options for how to increase low hemoglobin during pregnancy.

Eat more foods high in iron (eg Pomegranate during pregnancy >>>);
Take iron supplements as directed by your doctor.
Adjust your lifestyle: spend more time outdoors, avoid stress, allocate more time for sleep and rest, reduce physical activity.

Diet for low hemoglobin

First, you should try to do without medications, making your diet better. When planning your diet, it is important to know a few facts about iron and follow a number of rules:

Remember that you need to eat not only foods high in iron, but also foods and substances that help it to be absorbed in the body;

These are vitamin C, B9 and B12. Among the products that accelerate the absorption of iron, sauerkraut, citrus fruits, bananas, plums, pears, vegetables (except for leafy green vegetables) can be distinguished.

Products that prevent the absorption of iron by the body must either be limited in use, or not combined at one time with iron-containing foods;

Among them are calcium, cereals, corn, green leafy vegetables, dairy products (in particular, cheese, milk). Drinks such as tea, coffee, cocoa also inhibit the absorption of iron.

There are two types of iron: heme and non-heme. Heme iron is present in foods of animal origin: in meat and fish. It is best absorbed. Non-heme iron is found in plant foods: buckwheat, beans, peas, lentils.

What to eat with low hemoglobin during pregnancy?

Meat (beef, chicken, rabbit);
Offal (tongue, kidneys). The liver is rich in iron;
Oily fish;
Seafood, black and red caviar (current article: Fish and seafood during pregnancy >>>);
Buckwheat. It is most useful not to cook it, but to steam it;
Beans;
Rye;
Peas;
Lentils;
Potato baked with peel;
pumpkin seeds;
Mushrooms (dried ones contain much more iron than fresh ones);
Dried fruits (prunes, dried apricots, raisins);
Pomegranate juice;
Blueberry;
Apples (iron content is higher in dried fruits).

Treatment of anemia with iron supplements

Quite often, with anemia, doctors prescribe iron preparations in the form of tablets, solutions, syrups, injections.

Among them: vitamin B (cobalamin), Sorbifer Durules, Aktiferin, Maltofer, Ferrum-Lek, Ferroplex, Conferon, Tardiferon.

Important! In no case do not prescribe any medications to yourself, the selection of funds should be carried out by a doctor, taking into account your characteristics and situation.

Always read the instructions carefully. The intake of these drugs is not combined with many other drugs, in particular with some antibiotics, calcium preparations, etc.

Constipation leads to hemorrhoids, which can be painful. Therefore, first of all, try to raise iron with the help of changes in your diet + add vegetable syrups to your diet, which you will read about in the book “Secrets of Proper Nutrition for the Future Mom”.

The problem of low hemoglobin during pregnancy is quite common. If you are attentive to yourself and the baby, eat right and maintain an optimistic attitude, then it can be effectively solved.

Hemoglobin- This is a complex protein found in red blood cells (erythrocytes) and performs a respiratory function. Hemoglobin, binding oxygen, transports it to organs and tissues and takes carbon dioxide out of them. It is a complex protein, which includes iron.

The normal content of hemoglobin in the blood of a healthy woman before pregnancy averages 120–140 g/l.

Hemoglobin during pregnancy has other indicators. In the very first weeks after conception, an increase in the volume of circulating blood begins, which reaches its maximum by about the 36th week of pregnancy. The increase in blood volume occurs mainly due to the liquid part of the blood (blood plasma), which becomes larger by about 35-47%. The number of cellular elements, including erythrocytes (blood cells containing hemoglobin), also increases, but only by 11–30%. Since the increase in plasma volume significantly exceeds the number of red blood cells, the concentration of hemoglobin during pregnancy decreases, and the so-called.

Causes of low hemoglobin during pregnancy

The main causes of low hemoglobin during pregnancy are lack of dietary iron intake.

The need for iron during pregnancy increases significantly. It is spent on the formation of fetal tissues, its hematopoietic system, the construction of the placenta, as well as on the increase in the muscles of the uterus during pregnancy. The most active loss of iron begins at 16–20 weeks of gestation, which coincides with the period of the onset of hematopoiesis in the fetus. If the reserves of this element in the body of the expectant mother are depleted, iron deficiency anemia of pregnant women develops. More often it occurs in the second or third trimesters.

There are situations when low hemoglobin during pregnancy is detected already in the very first blood test taken when the expectant mother is registered in the antenatal clinic. This suggests that anemia started before pregnancy due to insufficient intake of iron, poor absorption or active destruction of red blood cells in the body.

In addition to iron deficiency, sometimes the causes of low hemoglobin during pregnancy can be a deficiency of vitamin B12, folic acid, hereditary diseases, conditions in which the body produces proteins that destroy its own red blood cells, severe bleeding.

How does a decrease in hemoglobin occur during pregnancy?

Normally, hemoglobin decreases gradually during pregnancy, and most often this is not accompanied by any obvious manifestations. Even with the development of anemia, the symptoms can be so insignificant that the expectant mother simply does not notice them, attributing the malaise to the peculiarities of her pregnancy.

The main manifestations of iron deficiency:

weakness,
fatigue,
tinnitus and dizziness,
shortness of breath on exertion,
fragility of nails and hair,
dryness and pallor of the skin,
taste perversion (the desire to eat chalk, sand, toothpaste and other inedible things),
the emergence of cravings for the smells of paint, acetone, gasoline.

Since anemia develops gradually during pregnancy, its signs do not appear sharply, but slowly, over time. It all starts with weakness, fatigue and drowsiness. If at this moment anemia during pregnancy is not detected and treatment is not started, the disease will progress.

The dangerous effect of hemoglobin deficiency on the fetus

Hemoglobin deficiency in expectant mothers can adversely affect the condition of the fetus and the course of pregnancy. With anemia, expectant mothers are more likely to be worried about early toxicosis, the risk of developing preeclampsia in the second half of pregnancy increases (it is manifested by increased pressure, edema and the appearance of protein in the urine), the threat of premature birth (that is, delivery before the 37th week of pregnancy) or abortion, significantly more often, placental insufficiency develops when it stops working normally and the baby begins to suffer from a lack of oxygen and nutrition. In addition, such women often have infectious complications after childbirth and produce less breast milk.

Anemia during pregnancy does not bypass babies. Children whose mothers suffered from iron deficiency during pregnancy are more likely to be born with low body weight, are more susceptible to various viral infections, they are more likely to have impaired speech development, decreased physical activity, psychological disorders, and also lower school performance in the future.

That is why the doctor in the antenatal clinic must prescribe a general clinical blood test three times during pregnancy: when registering, at 20 and at 30 weeks of pregnancy.

How to identify the causes of anemia during pregnancy?

First of all, in the presence of anemia, the doctor assesses the degree of decrease in hemoglobin, because the methods of treatment will also depend on this.

To clarify the causes of anemia, the doctor prescribes additional tests. For example, in a biochemical blood test, serum iron, transferrin, and ferritin are examined. These are special proteins in the blood that provide transport and storage of iron. In the general blood test, the color index, the average hemoglobin content in the erythrocyte, the total iron-binding capacity of the blood serum, and some other indicators are evaluated. These tests are needed by the doctor to diagnose the type of anemia and determine the tactics of treatment.

How to increase hemoglobin during pregnancy?

Expectant mothers with a severe degree of anemia are treated in a hospital, and those with mild and moderate anemia are treated on an outpatient basis. But if treatment is ineffective and hemoglobin continues to decline, this is also an indication for hospitalization.

If low hemoglobin is detected in the general blood test, and an additional examination confirms the presence of iron deficiency anemia, the doctor prescribes:

A diet high in iron. can increase hemoglobin during pregnancy. Your diet should include enough iron-rich foods. First of all, it is meat (pork and beef liver, veal, beef), eggs, bread, almonds, vegetables and fruits such as apples, pomegranates, apricots. Naturally, meat products should prevail in the diet, about 17–22% of iron is absorbed from them, and only 1–7% is absorbed from plant foods.
Medicines. For treatment during pregnancy, iron tablets are most often prescribed. Intramuscular and intravenous injections of iron preparations often cause complications. With intravenous administration, the development of disorders of the blood coagulation system is possible, with intramuscular injections, seals and abscesses may appear at the injection sites. Therefore, in pregnant women, injections of iron preparations are used only in severe cases and only in a hospital setting.

Iron tablets should preferably be taken on an empty stomach with water. Liquid forms of drugs can be dissolved in juices and it is recommended to drink them through a straw so that they do not cause blackening of the teeth, or rinse your mouth thoroughly immediately after taking them. You can not drink iron preparations with tea or milk, this will significantly reduce the absorption of this element.

What specific drug to treat, at what dose, how many times a day to take the medicine, how long the treatment will be, the doctor decides individually for each expectant mother. The doctor must also monitor the effectiveness of the treatment with the help of blood tests.

The level of hemoglobin rises, as a rule, by the end of the 3rd week of taking the drugs, but this indicator normalizes even later - after 9-10 weeks. At the same time, the well-being of a pregnant woman improves rapidly, usually after about two days from the start of treatment, she already notices that she feels better. A control complete blood count is usually taken about a month after the start of iron supplementation. After normalization of hemoglobin levels for a long time (approximately 2-3 months), it is recommended to continue taking iron supplements to maintain the effect of treatment.

How to avoid a decrease in hemoglobin?

In non-pregnant women, the iron requirement is 1.5 mg per day. During pregnancy, it steadily increases: in the first trimester up to 2.5 mg per day, in the second trimester - up to 3.5 mg per day, in the third trimester - up to 5-6.5 mg per day. In addition, significant (up to 700 mg) are inevitable during childbirth and another 200 mg of iron are consumed during the breastfeeding period. From this it is clear that iron deficiency is most susceptible to women who have given birth several times, patients with bleeding during previous births, mothers who have been breastfeeding their baby for a long time, women who have had a second pregnancy earlier than 4–5 years after the previous one. They are at high risk for developing iron deficiency anemia.

This group also includes women who follow a vegetarian diet, have chronic diseases of the gastrointestinal tract, kidneys, liver, gynecological problems such as endometriosis, uterine fibroids, as well as expectant mothers with pregnancy complications (for example, placenta previa, exacerbation of chronic diseases). during pregnancy, infections during the period of expectation of the baby). For such women, the doctor, in addition to an iron-rich diet, prescribes prophylactic iron supplementation, usually this is done in the second and third trimesters of pregnancy. All expectant mothers who are not at risk are prescribed iron as part of combined vitamin and mineral complexes for pregnant women.

An important moment in the life of every woman is the birth of a child, so during pregnancy she pays close attention to her health. The body of the future lobe is affected by various external factors that can provoke various changes in the body. in pregnant women it can be diagnosed for many reasons, and in order to avoid various deviations in the development of the child, it is important to start treatment as early as possible.

To determine the amount in the body of the expectant mother, a general blood test is prescribed. During this procedure, a small amount of blood is taken, which is subsequently studied in the laboratory.

It is important to remember that the reliability of the results obtained may depend on various factors, so preparation for requires compliance with several rules:

The sampling of material for research is carried out in the morning period of time and always on an empty stomach. A woman is allowed to eat for the last time 12-14 hours before the scheduled time of the procedure.
Various thermal procedures can distort the results of the study, therefore, before a general blood test, it is recommended to refuse to visit baths and saunas, and also to avoid strong physical exertion
During pregnancy, women constantly visit various specialists who conduct examinations and monitor her condition. On the day of the analysis, you must first donate blood for research and only after that go to other doctors.
Approximately 5-10 minutes before the general blood test, you need to rest a little, restore breathing and get rid of feelings of anxiety.
Often, the diagnosis of various pathologies during pregnancy involves several, which are done at regular intervals. In the event that a future mother is scheduled to conduct a second blood sampling, then this must be done at the same time as the previous analysis.

Compliance with such elementary rules allows you to obtain reliable results of the study, and if necessary, prescribe effective treatment and prevent the development of many complications.

Causes of a decrease in hemoglobin

During pregnancy, blood levels become a real problem for many women. This is due to the fact that the field of successful conception and throughout the entire period there is often a decrease in the level of hemoglobin in the female body. Often, experts diagnose an increase in such a coloring matter, which can also adversely affect development.

Most often, a decrease in the level of hemoglobin in the blood is noted in the second trimester, and until that time, the level of such a coloring matter in the body of a future mother is no different from ordinary people.The norm of hemoglobin in the body of a healthy woman, both during pregnancy and in the normal state, is 120-150 g / l of blood.

After about 20 weeks of pregnancy, there is a decrease in the level of iron-containing protein in the female body and this happens for the following reason: the volume of circulating blood increases, but the number of its components remains at the same level. This is due to the fact that the placental circle of blood circulation appears, which delivers all the necessary nutrients to the developing fetus.

During pregnancy, the hemoglobin rate in the 2nd and 3rd trimester is 110-140 g / l of blood.

In addition, a decrease in hemoglobin during pregnancy can occur for the following reasons:

The fetus is developing intensively and needs a large amount of vitamins, and. The result of this is a decrease in the concentration of iron in the mother's blood and, accordingly, hemoglobin falls.
A decrease in such a coloring matter in the blood can be observed during multiple pregnancies, as the consumption of such an element as iron increases.
A deficiency of various trace elements necessary for the normal functioning of the female body and the development of the fetus can become a cause during pregnancy.
A low hemoglobin level in a future mother can be diagnosed if the period between previous pregnancies is too short. The risk of developing anemia increases if the patient gave birth to a child less than 3 years ago. This is due to the fact that the replenishment of iron and other important trace elements occurs approximately three years after the birth of a child.
To provoke a decrease in hemoglobin during pregnancy can take certain groups of drugs. It is for this reason that taking various medications during pregnancy is allowed only after consulting a specialist.

More information about anemia during pregnancy can be found in the video:

The reasons for the decrease in the level of iron-containing protein during pregnancy can be different, and often this pathological condition develops under the influence of the following factors:

the presence of bleeding in the woman's history
changes in hormone levels
frequent nervous tension
intestinal dysbacteriosis
period of exacerbation
severe toxicosis

Medical practice shows that the maximum decrease in hemoglobin is diagnosed by the 32-33rd week of pregnancy, and by the time of childbirth, its content rises on its own.

Symptoms of anemia

In the event that the expectant mother has low hemoglobin, then this is usually accompanied by the appearance of characteristic symptoms.

It has characteristic features that any woman will be able to notice:

staining the lips, nostrils and mucous membranes blue
the appearance of circles under the eyes
weakness, which is accompanied by bouts of nausea and itching in the ears
sleep problems appear
skin turns pale
breathing becomes noticeably quicker and there is a feeling of lack of air
development of tachycardia and migraine
hair becomes brittle and falls out badly
problems with stool in the form of constipation
appetite is reduced or completely absent, but often this condition is replaced by a desire to eat everything

When such symptoms appear, a woman is recommended to visit her doctor, because the timely diagnosis of a low hemoglobin level will help to avoid the development of many complications.

In fact, a decrease in hemoglobin during pregnancy is considered a rather dangerous condition for the following reasons:

causes fetal hypoxia and developmental delay
can cause toxicosis in the last months of pregnancy
causes premature onset of labor and rupture of amniotic fluid
can cause complications during childbirth such as the appearance and weakness of contractions

During labor, mothers with a low hemoglobin content in the blood suffer from weakness of the labor forces, and often the result is hypotension of the uterus. In fact, hypotension of the uterus is considered a dangerous complication after childbirth and is accompanied by the appearance of bleeding. In addition, women with low levels of this iron-containing protein give birth to children with various problems.

Anemia during pregnancy causes the developing fetus to receive insufficient amounts of nutrients and oxygen.

The result of this is the birth of a baby with low body weight and underdevelopment.Medical practice shows that a low level in a woman during pregnancy causes frequent infectious diseases in children.

In addition, such children in the future will noticeably lag behind in physical and neuropsychic development, and they are often diagnosed with pathologies of internal organs. It is for this reason that when low hemoglobin is detected during pregnancy, it is necessary to undergo mandatory treatment.

Ways to increase hemoglobin

In the event that a woman is diagnosed with a low level of hemoglobin during pregnancy, then the expectant mother must be observed by a therapist. Good nutrition and intake of iron-containing vitamin-mineral complexes helps to normalize the hemoglobin content in a woman's body.

In order to avoid problems with stools and indigestion, it is recommended to engage in moderate physical activity and walk more often in the fresh air.

To restore the level of iron-containing protein in the female body, it is recommended to fill your diet with the following foods:

eggs
fish
liver
buckwheat
grenades
spinach

Thanks to this, it is possible to prevent the development of anemia during pregnancy, however, if it is present, it is unlikely that it will be possible to cope with it without medication. Many expectant mothers have an erroneous opinion that taking medications can have a negative impact on the development of the child. In fact, this is not the case and the benefits of such drugs are much greater than the possible harm.

During pregnancy, to restore the level of hemoglobin in the blood, the following iron supplements are recommended:

Fenyuls
Aktiferrin
Maltofer
Sorbifer

Usually a woman is prescribed a certain course of treatment, and its duration depends on the degree of anemia. For better absorption of iron, the intake of drugs that contain vitamin C is prescribed.

Subject to the necessary preventive measures, anemia in women during pregnancy may not appear. The expectant mother is recommended to walk in the fresh air as often as possible and be sure to lead a healthy lifestyle.

In addition, it is important to monitor your diet and fill it with products with the necessary content of trace elements and important substances.

To avoid various complications during pregnancy allows its planning, as well as the passage of treatment when detected. Before planning a child, it is important that normal blood counts be maintained for several months. If necessary, a woman is prescribed iron-containing preparations throughout the entire period of pregnancy and until the very birth.

Pregnancy is characterized by an increased consumption of all nutrients. Since during this period the woman's body must support not only itself, but also provide building material for the baby. In the intrauterine state, the child grows as never before at a tremendous rate.

Anemia is the most common disease of women during pregnancy. It occurs both independently and as a complication of other diseases. This condition poses a risk to the health of the fetus in the first place, but the mother's body also feels the disadvantage.

What is anemia?

Anemia is a decrease in the level of hemoglobin and / or red blood cells in the peripheral blood.
The normal level of hemoglobin is considered from 120 g / l. Considering that the fetus requires resources from the mother, the amount of hemoglobin in pregnant women will be in the range of 110 g / l.

There are several degrees of severity of anemia:

A mild degree is characterized by a hemoglobin content within 109-90 g/l ;
With an average degree, hemoglobin drops to numbers 89-70 g/l ;
Severe anemia is characterized by a drop in hemoglobin levels below 69 g/l .

The norm of hemoglobin during pregnancy should be considered individually, taking into account the trimester and the presence of concomitant diseases.

Causes of a decrease in hemoglobin in pregnant women

By the third trimester, the volume of circulating blood increases. Thus, dilution occurs, and hemoglobin becomes less in relation to volume. Therefore, by the end of pregnancy, the number of women with anemia increases.

If a woman's hemoglobin level is below normal in the initial stages or fluctuates in the lower normal range, such pregnant women should be observed and preventive treatment should be carried out.

Women who suffer from the following conditions are at risk for anemia:

Pregnant women with chronic diseases. For example, hepatitis, gastritis, peptic ulcer of the gastrointestinal tract, pyelonephritis, helminthic invasions;
With a diet with low meat intake, unbalanced nutrition (anarexia, vegetarianism);
The presence of blood clotting diseases (thrombocytopenia, coagulopathy);
Women who had a decrease in hemoglobin levels before pregnancy;
Complicated obstetric history (abortions, miscarriages, bleeding);
With multiple pregnancy;
With gestosis of the second half of pregnancy;
The age of the pregnant woman is up to 18 and after 32 years.

Manifestations of anemia

Anemia can pass without any symptoms, and often the expectant mother writes off minor changes in health as an “interesting” situation. But in more severe cases, the manifestations will be pronounced. Signs of anemia during pregnancy:

General weakness, including muscle weakness;
Pale coloration of the skin and mucous membranes;
Jams in the corners of the lips;
Changes in the perception of taste and smell (addictions to previously unpleasant odors);
There may be a rapid heartbeat, chest pain, shortness of breath;

Possible complications of pregnancy with anemia

Complications from the fetus are quite common, especially if a woman suffered from anemia even before conception and did not correct this condition.

Low hemoglobin during early pregnancy can lead to incorrect placement of the placenta. With anemia, underdevelopment, low location or complete blocking of the entrance to the uterus by the placenta occurs. All these changes and conditions can lead to abortion, bleeding, hypoxia (oxygen starvation) and fetal growth retardation.

In childbirth, women with low hemoglobin levels are more likely to suffer from weakness of the birth forces, which subsequently leads to hypotension (muscle relaxation) of the uterus. Hypotension of the uterus is a formidable complication of the postpartum period, which is manifested by bleeding. A newborn from an anemic mother is born with a number of problems.

Low body weight and underdevelopment at birth in a child is due to the fact that in utero the baby received an insufficient amount of nutrients and oxygen.

Children are born with an underdeveloped and unadapted respiratory system, they lag behind their peers in development, both physically and intellectually.

How to diagnose anemia

In addition to all clinical manifestations, a general blood test will help in making a diagnosis. The doctor pays attention to the following indicators:

The amount of hemoglobin, normal during pregnancy, is 110-150 g / l;
The level of erythrocytes in anemia is below 3.5 million.
The color index evaluates the level of hemoglobin in the erythrocyte (0.33-0.4);
Serum iron is determined in a biochemical blood test. The lower limit of the norm is 10 µmol/l.

In the third trimester of pregnancy, relative anemia can be observed. This means that the amount of hemoglobin remains the same, but the volume of blood has increased due to plasma. In this case, the diagnosis will help to determine the level of serum iron.

How to increase hemoglobin level?

A pregnant woman with a low level of hemoglobin should be observed by a general practitioner. In severe degrees, the absence of improvement from the use of drugs for 1.5 months or the appearance of complications, observation by a hematologist is indicated.

Treatment of even a mild degree of this disease with the help of diet therapy rarely brings positive effects. In any case, the recommended diet should be high in protein and iron. Products that should be included in the diet of a pregnant woman, even for preventive purposes:

Beef liver contains the most iron and protein;
Fish and seafood;
Veal meat, beef;
Cereals;
Spinach, lettuce.

Treatment with drugs consists of several stages. The first step is to restore hemoglobin numbers to normal levels. Given the abandoned depot, you need to restore the supply of iron. And subsequently, maintenance therapy is prescribed until the end of pregnancy.

Pregnant women, regardless of the level of hemoglobin, receive a prophylactic dose of iron and folic acid before the term of delivery;
If a decrease in hemoglobin is detected, the dose of iron is doubled;
The drugs are prescribed in tablets and only in especially severe cases, intravenous drugs and blood components are prescribed;

Ascorbic acid improves iron absorption. But during pregnancy, this vitamin should be used with great care and only after 37 weeks. In all other terms, the use of "ascorbic acid" can cause a threat of abortion. Preparations for the treatment of anemia during pregnancy: Ferronat, Ferlatum, Fefol, Ferretab, Totem.

Prevention of anemia

Iron deficiency anemia during pregnancy may not occur if proper prevention is carried out.

A woman should lead a healthy lifestyle, spend more time outdoors. Nutrition should be balanced in all trace elements and basic substances, contain meat and fresh vegetables.

Pregnancy must be planned. If anemia is detected, get treated. It is important that normal blood counts are maintained for several months before conception, in order to replenish the depot. The entire pregnancy will have to take iron supplements in a prophylactic dose.

Iron deficiency anemia - why we need iron

Iron is part of one of the most important proteins - hemoglobin, which is responsible for transporting air through the blood vessels. Despite the fact that the content of iron in humans is relatively low, its deficiency can result in serious problems.

Iron enters the body with food, but it receives only a small part of it. So, for example, a pregnant woman, adhering to a suitable diet, consumes about 15 mg of this substance per day, but the body gets only a small 15% of this mass - only 1-2 mg.

As the pregnancy progresses, so does the body's iron intake. This is due to the need to compensate for the large losses of this trace element - it is spent on the development of the fetus. The peak itself falls on the 4th month of the term, it is at this time that the bone marrow hematopoiesis of the fetus occurs, which causes an increase in the mass of blood in a woman. This is such a difficult process for the body that it lacks even the natural enhancement of iron absorption - up to 4 mg per day, almost twice as much as the norm.

What happens to iron in the body

Iron, as an element necessary for the body, is absorbed during digestion. It occurs in the jejunum and in the duodenum. And this process does not always go smoothly. It all depends on how healthy a person is - all sorts of chronic diseases of the intestines and stomach can significantly complicate the absorption of iron.

In addition, the level of this trace element in the body has a great influence.

Medications taken with food, as well as the product in which we consume iron and the food that gets inside with it, have a significant effect.

The latter factors are actually not as innocent as they seem at first glance. Iron is a complex element and can be found in food in two forms. Depending on the form, the level of its assimilation also changes. So, heme iron, which is part of hemoglobin, loses protein bonds during digestion and is absorbed by the inner lining of the intestine. At the same time non-heme iron that exists outside the protein is absorbed much worse.

Heme iron is also important because it is this type that is found in hemoglobin. It is present in foods such as fish and meat - especially liver. Its absorption rate is 25%, while the absorption of non-heme iron is from 1% to 15%, depending on the type of product consumed.

With this difference in absorption, non-heme iron makes up a significant portion of dietary iron. In addition, one should remember about the valence of iron - bivalent is absorbed better, and trivalent, respectively, is worse.

To increase the absorption of this trace element, it is necessary to control the composition of the food consumed in order to monitor which products enter the intestine at the same time. Their combination affects the percentage of dissolution of non-heme iron. For example, Vitamin C, which is an essential catalyst for the absorption process, is of great importance. This is due to the oxidation of iron elements and its transformation from a trivalent form to a divalent one.

On the other hand, consuming a lot of foods containing copper, zinc, or manganese can make it harder for the body to absorb iron. The fact is that these elements come from the intestines into the body with the help of a special transporter protein, which is also responsible for the entry of iron into the initial part of the small intestine. Thus, a large amount of zinc and copper creates too much load on this protein, making it difficult for it to perform its function of transporting iron.

Calcium has a similar property. However, in this case, one should be extremely careful - during pregnancy, a shortage of this element should not be allowed.

Calcium is an important resource for a heavily stressed body. Therefore, it is worth resorting to, so to speak, separate nutrition and consuming calcium after consuming iron, making sure that more than 4 hours have passed between meals or a vitamin. In practice, this is expressed much more simply - before eating foods or medicines containing iron, it is better to bypass foods that contain calcium: dairy foods, cheeses and green vegetables.

During pregnancy, you should be aware of the division of products into those that promote the absorption of iron and those that hinder this process. The first ones include:

especially meat and fish. They contain such important proteins as myoglobin and hemoglobin, as well as vital lysine, cysteine and histidine. These are amino acids that promote the absorption of iron;
fermented milk products such as kefir, fermented baked milk, acidolact;
foods containing vitamin C (they include the acids necessary for the absorption (citric, acetic), namely, citrus fruits, bell peppers, plums, apples, pears, bananas, beets, carrots, tomatoes, pumpkin, potatoes and even sauerkraut. This food is also important for its content of essential simple carbohydrates, in particular fructose.

At the same time, they have a negative impact:

cereals, bran, corn;
legumes - they contain phytic acid and its derivatives - phosphates and phytates, which impede the absorption of iron, as well as coarse dietary fiber;
tea, both black and green;
green leafy vegetables and spinach - it contains polyphenols and oxalic acid;
products containing calcium (milk, both hard and soft cheeses, cottage cheese), as well as eggs - they include complex phosphoprotein proteins;
disodium ethylenediaminetetraacetic acid, used in canned foods as a preservative.

What causes iron deficiency anemia

As we have already said, anemia is a disease in which the level of hemoglobin in the blood is low. A special case of the disease - iron deficiency anemia - occurs due to a lack of iron necessary for protein synthesis.

Most prone to developing this disease are women suffering from chronic tonsillitis, heart defects, diabetes, gastritis, rheumatism, etc., as well as women with abundant menstrual flow.

In addition, at risk are often pregnant women who are already iron deficient during previous childbearing, pregnant at an early age and pregnant while breastfeeding. The prerequisites for the development of anemia can be a low level of hemoglobin in the first trimester (below 120 g / l), severe toxicosis in the early stages, threats of miscarriage and viral diseases transferred at this time, as well as multiple pregnancy and polyhydramnios.

The disease can also make itself felt due to the low consumption of meat - therefore, strict vegetarians should be especially careful - and as a complication after suffering pyelonephritis, viral hepatitis and dysentery.

How to treat iron deficiency anemia

The treatment process takes a long time and is carried out by taking drugs containing ferrous iron. However, if you do not speed up recovery, then you can definitely ease the expectation of its onset with the help of a simple but incredibly healthy diet.

First of all, it is necessary to include proteins in the diet that favorably affect the synthesis of hemoglobin - they should be about 130 g per day (a little more can be), and about 90 g should come from animal proteins.

It should be borne in mind that anemia often causes the deposition of excess fat in the cells of the bone marrow and liver. Therefore, it is worth reducing the consumption of fats (no more than 80 g), and, conversely, increasing the intake of foods that help normalize cholesterol and lipid metabolism in the body. This is cottage cheese oatmeal and buckwheat, vegetable oil, lean meat and fish.

Of course, products containing iron and vitamins of groups C and B, in particular, B12, are mandatory - first of all, these are liver and brains (exclusively beef), beef meat itself, fish, bran, millet. It is also necessary to consume such trace elements as cobalt, copper and manganese, as well as the above products that contribute to the high absorption of iron.

What to eat with anemia - the right diet

Despite the fact that with anemia it is natural to lack appetite, it is necessary to adhere to a clear nutrition schedule, based on the following schedule:

two breakfasts with a break of two to three hours. The dishes that make up the first tomorrow should be denser and more satisfying; light, steamed fish or fresh vegetables are recommended for the second breakfast;
lunch, which necessarily includes soup or chicken broth, a second course and fruit;
light afternoon snack (jelly, fresh fruit, tea with crackers);
dinner, which includes several dishes (cottage cheese, vegetables and meat);
a glass of kefir or fermented baked milk before going to bed.

At the same time, you should not panic and limit yourself in everything - there are no fundamental dietary restrictions for iron deficiency anemia. From the diet it is worth excluding only what is contraindicated for all pregnant women - strawberries, raspberries, coffee and cocoa, chocolate and seafood. At the same time, bread, like simple carbohydrates, does not belong to such products. On the contrary, it can be useful in reasonable doses - both black and white, but not more than 200 g per day.

Thus, the main rule to be followed is to know the measure in everything. For example, you should not eat only meat, as the main source of iron, because there will be absolutely no benefit from this, and you can only harm your health. There is no need to try to eliminate iron deficiency only through diet - for this you will have to increase the amount of food consumed several times, because. the percentage of the suctioned element always remains the same. Therefore, the most correct way is a combination of competent nutrition with the intake of medications prescribed by a specialist.

The range of iron-containing medicines is very large, so trying to choose them for yourself can be dangerous - you must definitely entrust this to your doctor.

The ideal option, of course, is the prevention of anemia. When planning pregnancy, you should keep it in mind in any case, not to mention those cases where a woman falls under at least one risk factor. Both before pregnancy and during, it is necessary to do a biochemical blood test for such an important indicator as serum iron - this will give a complete picture of the content of the element in the body.

In addition, it will not be superfluous to periodically check the general blood test for the level of hemoglobin and red blood cells. This will help keep the situation under control and prevent the possible development of this serious disease.

The description of pregnancy as a period of joyful expectation of a baby, unfortunately, does not always correspond to reality. For a long 9 months, a woman is faced with various ailments that she had not encountered before.

One of the important indicators of a woman's health is the normal level of hemoglobin in the blood, which for various reasons may deviate from the norm. This will not bring special problems for the unborn child if you see the changes in time and take the necessary measures.

Hemoglobin and its meaning

Hemoglobin is a complex protein that is a component of the blood and is responsible for delivering oxygen to all organs. Carriers of hemoglobin are small red bodies called erythrocytes. Depending on their amount in the blood, one can also judge the level of hemoglobin, which is necessary for the optimal functioning of all organs, the growth and development of the baby. Accordingly, during pregnancy, the health and even life of the child may depend on the level of hemoglobin.

Depending on the lack of hemoglobin, there are three degrees of anemia:

mild - hemoglobin index 90-110 g/l;
medium - hemoglobin index 70-90 g / l;
severe - hemoglobin index less than 70 g / l.

Features of the manifestation of anemia

Almost half of all pregnant women experience a lack of hemoglobin at one time or another. In order to diagnose the problem in a timely manner, registered women are offered to periodically take tests. The future mother can determine the lack of hemoglobin on her own, noting the following symptoms:

constant weakness, very fast fatigue;
periodic dizziness, the appearance of "flies" before the eyes;
pallor of mucous membranes, skin;
palpitations, the possibility of fainting;
the appearance of tinnitus, as well as shortness of breath at the slightest physical exertion;
headaches, insomnia;
dryness and pallor of the skin, bluish color of the lips;
brittle nails and split hair;
constipation;
strange taste preferences that have not previously been noted.

Causes of anemia

The amount of blood naturally affects the decrease in hemoglobin levels: the larger its volume, the less hemoglobin it contains. A growing baby with each week of pregnancy takes more and more iron. Especially often there is a lack of hemoglobin in multiple pregnancies.

Anemia can also be caused by a lack of certain elements in the body. For example, folic acid, zinc, copper, vitamin B12 are involved in the absorption of iron. Without them, the amount of absorbed iron is sharply reduced. That is why proper nutrition of the expectant mother plays a key role in preventing the appearance and development of anemia.

The main causes of hemoglobin deficiency are:

serious diseases of internal organs: heart disease, hepatitis, pyelonephritis;
toxicosis in the first months of pregnancy;
a short break between two pregnancies (experts recommend taking a break of at least 3 years, during which the body is able to restore iron stores);
constant stress;
taking certain medications;
dysbacteriosis.

Most often, pregnant women with iron deficiency encounter in the second half of pregnancy. After 20 weeks, the baby is already quite large. The mother's blood volume increases significantly, and iron intake increases, which leads to its deficiency. The maximum decrease in hemoglobin is usually noted by 32-34 weeks.

If the decrease in hemoglobin level occurred at the end of pregnancy, then special treatment in this case is not prescribed. Immediately before childbirth, its blood counts usually level off on their own.

A physiological drop in the amount of iron must be distinguished from changes that require medical intervention. Its deficiency can lead to oxygen starvation of the baby with the subsequent development of hypoxia. Anemia can cause late toxicosis, as well as untimely discharge of amniotic fluid.

A low level of hemoglobin can lead to complications during childbirth, for example, weak labor, premature birth, heavy bleeding, and even death of the baby in the first day of life.

A toddler can be born with a small weight, be extremely susceptible to infections. That is why you need to constantly monitor the level of hemoglobin in order to timely see its deficiency and calculate the rate of decrease in its amount in the blood.

Prevention and treatment of low hemoglobin in pregnant women

The safest way to treat anemia is to prevent it. It is necessary to take the complexes of vitamins and minerals recommended by the doctor. The range of foods rich in iron is quite diverse, so there should be enough of them in the diet of the expectant mother. Among them are buckwheat, meat, liver, fish, apricots, eggs, rye, beets, peaches, dried mushrooms, parsley, carrots, legumes, pomegranates, pomegranate juice, and persimmons.

Iron is best absorbed from animal products - up to 6%, while plant foods can only provide 0.2%. Walking in the fresh air, taking ascorbic, folic acid also contribute to the increase in digestibility.

Doctors note that without iron-containing drugs, the treatment of anemia is impossible, since an insignificant amount of the necessary iron enters the body with food. Treatment can last for several months. If a woman does not tolerate pills, then injections are used.