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« Long-term Outcome in Immune Thrombocytopenic Purpura | Immune Thrombocytopenic Purpura in Pregnancy »

Wednesday

Apr072010

Haematological changes during Pregnancy

Wednesday, April 7, 2010 at 9:48PM

Pregnancy is a time of stress, no doubt about it. Stress to the prospective mother for obvious reasons. It is a time of apprehension and uncertainty, be it

the first or the tenth pregnancy. It is also a time of stress for the body, where adaptation were needed to accommodate the growing baby. It is also a time

of stress for the father. I know. My wife has been pregnant twice before ….. Need I elaborate?

During pregnancy, haematologically, our body makes two main changes - 1) increasing the efficiency in oxygen delivery to the growing foetus; and 2)

adjustment to reduce the possibility of bleeding. Pregnancy is a time when clot are easily formed, sometime to the extend that blood clot can be formed in

circulation, causing deep vein thrombosis.

To do the above, we can observe the following five changes - 1) physiological anaemia - drop in haemoglobin level by the increase in amount of circulating

plasma, the liquid part of the blood. 2) Increase in the neutrophil count, the group of white blood cells which fights infection. 3) Mild thrombocytopenia -

small drop in platelet count, again due to increase in the amount of plasma. 4) There is also an increase in clotting protein, making the body prone to form

clot and 5) reduced fibrinolysis, reduction in our body’s ability to dissolve blood clots formed in the body. In most instances, these changes goes

unnoticed, but those who chose to have blood screening may be alarmed to learned of them and may want to consult a doctor for advice.
The increase in plasma volume is something that pregnant mothers noticed first. They often complained of weight gain and swollen ankle. These does not

need treatment and certainly they should not limit the amount of fluid intake. This is due to hormonal changes during pregnancy, which will return to

normal following delivery. Despite the anaemia, the amount of red cell actually increased, as reflected by the increase in the need for iron and folic acid.

These are normally given to pregnant mothers as supplement and in the scheme of things are very important. On average, a pregnant mother will require

an extra 1 gram of iron throughout a pregnancy. Taking folic acid will also reduce the chance of spina bifida in the baby. These supplements reduces the

chance of early labour.

We are not really sure of the reason of why the white blood count increases during pregnancy. It can be confused with underlying infection in the pregnant

mother as this is usually the case in a normal individual. The WBC count can reach as high as 30 without any problems. Therefore monitoring and

reassurance in important, without a need for specific intervention.

As for the clotting levels, it may not become obvious as it is not usually included in standard screening tests, but suffice to say the essay of individual

clotting factor essays are not needed unless there is a specific reason. These changes should return to normal once delivery of the baby is completed.

by Haris Abdul Rahman | Permalink | Share Article

tagged Pregnancy in Basic, Investigations, Pregnancy

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harisrahman 1 month ago

From twitter via BackType One more retweet from haemummc

• Haematological changes durng pregnancy http://bit.ly/abF9Vc

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