Government College of Nursing Jodhpur: Presentation On Anemia and Nutritional Deficiency

GOVERNMENT COLLEGE OF NURSING
JODHPUR
SUBJECT – Obstetrics and

gynecology nursing
Presentation
On
Anemia and nutritional deficiency
SUBMITTED TO: SUBMITTED BY:

Jyoti bala Jangid
Nursing lecturer PRIYANKA GEHLOT
GCON, JODHPUR
ANEMIA AND NUTRITIONAL DIFICENCY

INTRODUCTION:
Anemia in pregnancy is a major health problem in developing countries. More than two
thirds of the pregnant women in India are anemic and most of times it is due to deficiency of
iron and folic acid.
Anemia is a major killer in India. One in every five maternal deaths is directly due to
anemia. Anemic patients have poor tolerance for potential blood loss during deliver and are
poor subjects for surgery. For this purpose, screening for anemia is routine in all antenatal
clinics. Anemia is the commonest hematrological disorder that may occur in pregnancy.
DEFINITION:
Anemia (An-without,emia-blood)is a decrease in the RBC count, hemoglobin and/or
Hematocrit values resulting in a lower ability for the blood to carry oxygen to body tissues.
TYPES OF ANEMIA DURING PREGNANCY
Types of anemia can develop during pregnancy. These include:
 Iron-deficiency anemia
 Folate-deficiency anemia
 Vitamin B12 deficiency
IRON DEFICIENCY ANEMIA
 About 95% of pregnant women with anemia have iron deficiency type.
 A pregnant woman is said to be anemic if her haemoglobin is less than 10 gm/dl.
 This type of anemia occurs when the body doesn't have enough iron to produce adequate
amounts of hemoglobin. That's a protein in red blood cells. It carries oxygen from
the lungs to the rest of the body.
 In iron-deficiency anemia, the blood cannot carry enough oxygen to tissues throughout
the body.
FOLIC ACID DEFICIENCY ANEMIA (MEGALOBLASTIC ANEMIA):-
• Folic acid deficiency anemia happens when body does not have enough folic acid.
• Folic acid is one of the B vitamins, and it helps your body make new cells, including new
red blood cells
• Deficiency of folic acid can cause placental abruption, nueral tube defect and congenital
cardiac septal defects
VITAMIN B 12 DEFICIENCY
Vitamin B12 deficiency, also known as hypocobalaminemia, refers to low blood levels of
vitamin B 12. Deficiency of vitamin B 12 can also produce megaloblastic anemia. The body
needs vitamin B12 to form healthy red blood cells. When a pregnant woman doesn't get enough
vitamin B12 from their diet, their body can't produce enough healthy red blood cells. Women
who don't eat meat, poultry, dairy products, and eggs have a greater risk of developing vitamin
B12 deficiency, which may contribute to birth defects, such as neural tube abnormalities, and
could lead to preterm labor. Blood loss during and after delivery can also cause anemia.
CAUSES
• Reduced intake or absorption of iron
• Excess demand such as multiple pregnancy
• Blood loss.
SIGNS AND SYMPTOMS OF ANEMIA-

1. Mild anemia-
 The patient has no complaints specific to anemia. Diagnosis is made on routine blood
examination.
2. Moderate anemia-
 The patient may complain of:
 There is pallor of the sclera of the eyes, lips and the nail bed.
 Excessive tiredness.
 Palpitation .
 Occasional breathlessness, especially during exertion such as on climbing stairs.
3. Severe anemia-
The patient with severe anemia has acute signs and symptoms:
 She looks ill exhausted.
 There is breathlessness and palpitation even on resting.
 Some patients prefer to sleep in a propped up position rather than lying down, to
decrease breathlessness.
 Ulcers of the lips and gums may occur.
 Edema all over the body.
 Enlargement of the heart and cardiac murmers due to severe anemia may lead to
congestive cardiac failure.
EFFECTS OF ANEMIA ON THE MOTHER
• Reduced resistance to infection.
• Reduced ability to withstand postpartum haemorrhage
• development of heart failure if anemia is severe.

• Predisposition to PIH and preterm labour due to associated malnutrition
• Reduced enjoyment of pregnancy and motherhood owing to fatigue
• Potential threat to life.
EFFECTS TO FETUS/ BABY
• Intrauterine hypoxia and growth retardation
• Prematurity
• LBW
• Anemia a few months after birth due to poor stores
• Increased risk of perinatal morbidity and mortality
INVESTIGATION
 History taking
 Physical examination
 Blood investigations
 Hb%
 CBC (Complete Blood Count)
 PCV (packed cell volume)
 RBC (Red Blood Cell)
TREATMENT
Women having haemoglobin level of 7.5 mg% and those associated with obstetrical medical
complications must be hospitalized
 Diet
 Antibiotic therapy
 Blood transfusion
 Iron therapy which may be oral/ parental
 Oral iron: daily dose 120- 180 gm is given.
PREVENTION
The midwife can help to identify women at risk of anemia by -
 Accurate history of medical, obstetric and social life • Avoidance of frequent
childbirths
 Supplementary iron therapy
 Dietary advice
 Adequate treatments to eradicate illnesses likely to cause anemia
 Early detection of falling hemoglobin level.
 Avoid excessive blood loss during the second stage of labour.
 Women need to be taught about sources of iron.
Management during labor
1 st stage of labour
 Special precautions
 Comfortable position on bed
 Light analgesia
 Oxygenation to increase oxygenation of maternal blood and prevent fetal hypoxia
 Strict asepsis
2 nd stage of labour
Asepsis is maintained.
Prophylactic low forceps or vaccum delivery may be done to shorten the duration of second
stage.
Intravenous methargin 0.2 mg should be given following the delivery of anterior shoulder.
3 rd stage of labour
Intensive observation.
Blood loss must be replaced by fresh pack cell and amount must not exceed loss amount to
avoid overloading
Puerperium
Bed rest Sign of infection detected and treated Pre delivery iron therapy must be continued
until patient restores. Die Patient and family members must be counseled for help at home
regarding baby care and household chores
SUMMARY:
Today we discussed definition of anemia, classification of anemia risk factors, causes sign
and symptoms, investigation, treatment and management of anemia.
CONCLUSION
Anemia in pregnancy is the most commonly occurring disorder during pregnancy, so every
mother who are pregnant must screen for anemia and must take treatment as soon as possible
along with foods rich in iron and also must have family support and care throughout
pregnancy.
BIBLIOGRAPHY
1. DC Dutta. Textbook of Obstetrics. 8th edition. Jaypee brothers Medical Publishers.
2. Annamma Jacob. A comprehensive textbook of Midwifery & Gynecological Nursing.
3rd edition. Jaypee Brothers Medical Publishers.
3. Nima Bhasker. Midwifery & Obstertrical Nursing. 2nd edition. Hardiya Publication.
4. BT Basavanthappa. Essentials of Midwifery & Obsterrical Nusrsing. 1st edition.
Jaypee Brothers Medical Publisers.

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GOVERNMENT COLLEGE OF NURSING

SUBJECT – Obstetrics and

SUBMITTED TO: SUBMITTED BY:

Nursing lecturer PRIYANKA GEHLOT

ANEMIA AND NUTRITIONAL DIFICENCY

TYPES OF ANEMIA DURING PREGNANCY

Types of anemia can develop during pregnancy. These include:

FOLIC ACID DEFICIENCY ANEMIA (MEGALOBLASTIC ANEMIA):-

• Excess demand such as multiple pregnancy

SIGNS AND SYMPTOMS OF ANEMIA-

EFFECTS OF ANEMIA ON THE MOTHER

• Reduced resistance to infection.

• Reduced ability to withstand postpartum haemorrhage

• development of heart failure if anemia is severe.

• Reduced enjoyment of pregnancy and motherhood owing to fatigue

• Potential threat to life.

EFFECTS TO FETUS/ BABY

• Intrauterine hypoxia and growth retardation

• Anemia a few months after birth due to poor stores

• Increased risk of perinatal morbidity and mortality

Management during labor

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