©Pregnancy bliss 2008

Continued from previous page

 

Determining the levels of iron reserves in the body

This is easily done by estimating the levels of a certain blood protein called Ferritin. This protein accurately reflects the long-term iron store levels.

 

To take or not to take oral iron supplements during pregnancy

Except for those women who have specific conditions that contraindicate use of iron supplements, everybody else will benefit from oral iron supplements in pregnancy, some more so than others.

 

For those who embark on pregnancy with a good hemoglobin level and with good iron stores, the iron supplements may not give any clinically apparent benefit. They will, nonetheless, allow for maintenance of healthy iron stores, allowing for optimal production and function of various essential enzymes in all body systems.

 

That state will also mean a continued general well-being. Such a woman can and will tolerate unduly heavy blood loss much better. She will also go into the postnatal period a healthier person, better placed to face the challenges of new motherhood.

 

For women who are total vegans and those who embark on pregnancy while already anemic or with low iron reserves, the taking of oral iron supplements is imperative.

 

For those who cannot tolerate oral iron

For most, it is a question of getting the right brand. The doctor will strive to help the expectant mother to identify the right one for her. There are quite a few on the market and some women tolerate one brand better than the next. Ultimately, all brands deliver the same ingredient namely; iron.

 

The expectant mother should be encouraged to persevere because this is for her and her baby's own good. It is not simply a ritual.

 

Some women find it easier to tolerate liquid preparations.

 

When all these avenues fail, doctors have to assess the situation and decide whether the degree of deficiency and anemia warrants giving iron in the form of injections.

 

The "iron injections" option as a last resort in pregnancy

Even though this route replenishes iron stores more efficiently and usually more quickly, it is associated with potential problems and is therefore not a suitable first choice.

 

Some people develop an allergic reaction to it (and therefore a test dose in hospital is an absolute pre-requisite). Also, the injections have to be given deep in the muscle and are fairly painful. Moreover, there is a small risk of developing abscesses at the site of the injection.

 

There is also the fact that each course will consist of many injections (at least ten) which have to be administered either daily or on alternate days. This is certainly not everybody's cup of tea and it is evident that the oral route is, in many respects, a preferable option.

 

Taking iron after delivery

The degree of need for this is dependent on a few factors:

If the mother was taking iron during pregnancy because she was found to be iron-deficient, then it is advisable that she continues to take iron for several weeks (six to eight) after delivery. Other situations where this will be advised are:

If the blood loss at delivery was heavy, even if she was not particularly anemic during pregnancy, the advice will be to start or continue taking iron, again, for several weeks at least.

If she is breast-feeding, the need for iron supplements is increased.

If she is a total vegetarian, where the diet may not supply adequate iron, supplements are strongly advised.

 

Every individual woman's needs should be assessed and advice given accordingly. As a general statement, hemoglobin levels will tend to rise in the days and weeks after delivery. However, this does not mean that the need for iron is diminished or eliminated.

Next Page: Folic Acid deficiency

 

 

 

Folic acid-deficiency anemia in Pregnancy

 

How common is folic acid-deficiency anemia in pregnancy?

It is uncommon.