The reason may be TA if you have full body weakness, dizziness, shortness of breath, etc.

Author: Lin Yuxian, Department of Pharmacy, Fifth Hospital Affiliated to Guangzhou Medical University

If the following symptoms occur during pregnancy: full body weakness, dizziness, headache, pale skin or yellowing, shortness of breath, desire or chewing ice cubes (heterotrophic)In the manifestation, in severe cases, heartbeat may also be accelerated, hypotension, and difficult to concentrate.So, let’s take a look at what is anemia during pregnancy. What are you worth noting?

Anemia during pregnancy can be defined as follows:

● Early pregnancy -hemoglobin (HB) <110g/L [Hematocrit, HCT <33%)]

● Medium -term pregnancy -HB <105g/DL (HCT <32%)

● Adventure of advanced pregnancy -HB <110g/dl (HCT <33%)

● Postpartum -HB <100g/DL (HCT <30%)

From 2000-2019, 84 (81.6%) study reported that the prevalence of pregnancy was 10% to 40%, and the prevalence of anemia in my country generally showed a trend of decline over time.

The comparative analysis of the prevalence of pregnancy during different regions of China has found that the prevalence of anemia in women in rural and minority areas is higher.Compared with the prevalence of 10% to 40% of pregnancy in the eastern region, 20% to 40% of the disease level of 20% to 40% in the western region is slightly higher, and the prevalence of pregnancy in the central region is mainly at 10% to 30%.According to WHO’s severity of anemia, Chinese pregnancy anemia is mild to moderate public health.

However, existing research may have an underestimated disease rate, and the anemia rate has gradually increased with the increase in pregnancy.Women’s anemia is also more serious.Therefore, the prevention and control situation of Chinese pregnancy anemia is more severe. To achieve the goal of less than 10% of the 2030 of the "Healthy China Action (2019-2030)", it still faces greater challenges.

1. Physiological (dilution) anemia

The number of red blood cells during pregnancy increases, but physiological changes can lead to dilution anemia.At 6-12 weeks of pregnancy, the plasma capacity increased by 10%-15%, and continued to expand rapidly. After 30-34 weeks of pregnancy, it remained stable or decreased slightly until the full month.The total increase in the full month is 1100-1600ml, so that the total plasma capacity is 4700-5200ml, which is 40%-50%higher than before pregnancy.

2. Iron deficiency

Iron deficiency is the most common reasons for pregnancy -induced anemia (non -pathological).

Several factors that cause iron deficiency are:

● Insufficient meal iron.

● Blood loss caused by previous pregnancy and/or menstruation and short pregnancy interval.

● Due to the increased blood capacity of pregnant women and the needs of fetal red blood cells and the growth of fetal placenta, the demand for iron during pregnancy has increased significantly, as shown in the figure below (iron demand during pregnancy).

The figure shows the general requirements required for compensation for normal turnover (such as gastrointestinal tract), menstrual, maternal red blood cell blocks, and fetal and placental red blood cell demand.Weeks refers to pregnancy weeks.For details of the replenishment of iron during pregnancy and the treatment of anemia, please refer to UPTODATE.

• The total amount of iron demand accumulated in the growth of pregnant women and the growth of fetal red blood cells/fetal placenta growth is about 500mg and 300-350mg, respectively.

• The loss caused by childbirth is 250mg.

• Insufficient iron intake or absorption disorders caused by some cases will also increase the risk of iron deficiency during pregnancy, especially when women do not supplement sufficient iron.These conditions include nausea and vomiting during pregnancy, inflammatory bowel disease (IBD), weight loss surgery (such as stomach bypass surgery) and others.

3. Other reasons

Except for biological anemia and iron deficiency, other reasons for pregnancy are rare.Causes of hereditary and acquired anemia, especially mild anemia, may only cause clinical attention only when the prenatal routine laboratory examination or worsening during pregnancy.For example:

1. Abnormal hemoglobin disease (thalassemia, sickle cell disease)

2. Red blood cell membrane disease

3. Get sexual anemia

1. Pregnant women should standardize pre -delivery examinations, and regularly review HB during pregnancy;

2. Preparatory diagnosis and treatment of IDA can reduce the blood transfusion rate at birth.

3. Anemia anemia anemia for the cause before pregnancy. For non -anemia pregnant women with increased ID risk during pregnancy, or serum iron protein <30 μg/L, oral iron should be supplemented.At the same time, it is encouraged to supplement the rich and easy to absorb foods to reasonably balance the diet.

4. It is recommended to review the routine and serum iron protein for every 8 to 12 weeks of pregnancy.

It is worth mentioning that there are two forms of iron in food, which are the heme iron in animal sources and non -heme iron in plant -based foods.Animal red meat, liver, blood and other foods provided by foods are hemoglobin iron, and the absorption rate can reach more than 10%, which is significantly higher than the iron salt with plant sources. The absorption rate is usually <5%.

General principle:

1. Patients with iron deficiency (ID) and mild and moderate IDA are mainly oral iron therapy, improve diet, and eat rich iron -containing foods.

2. Patients with severe IDA need to be treated with oral iron or venous iron, and can also infuse the concentrated red blood cells multiple times, but it is not recommended to supplement the iron in early pregnancy.

3. Patients with extremely severe IDA preferred concentrated red blood cells. After HB reaches 70 g/L. After the symptoms are improved, they can be changed to oral iron or venous iron treatment. After the treatment until the HB is restored to normal, the oral iron agent should be continued 3 ~6 months or 3 months after delivery.

Common oral iron

Common oral iron



300 mg/time, 1 time/d

Protein Amber Iron Optotic Purifier solution

300 mg/time, 1 time/d


60 ~ 120 mg/time, 3 times/d

Amber sarcaine

100 ~ 200 mg/time, 2 times/d

Glucose sour

300 ~ 600 mg/time, 3 times/d

Spleen and blood slices

1 ~ 3 tablets each time, 3 times/d

Chinese medicine supplementation

300 mg/time, 1 time/d

Note: The proportion of iron contained in different iron agents is different. Please follow the doctor’s advice or consult the pharmacist when taking it.

The recommended dose of oral iron is 40 ~ 200mg of element iron per day, and 60mg elemental iron is often given, and iron is supplemented every day or every other day.

Although oral iron is safe, cheap, and easy to obtain, it may have some side effects of gastrointestinal tract, such as some pregnant mothers may appear after taking the medicine: darkened stools, constipation, metal flavor, stomach irritation, nausea, diarrhea, diarrhea, diarrhea, diarrhea

Trimming and urine discoloration.

If these situations occur, don’t be nervous, eat more fiber -rich foods, drink plenty of water to relieve discomfort. At the same time, take it after meals or during meals to reduce stomach stimulation.

1. Reducive foods that are absorbed by iron to avoid taking at the same time as iron agents, such as: coffee, tea, eggs, milk, milk, dairy products, soy products, wheat and miscellaneous grains and other grains.Essence

2. Calcium supplements or calcium -containing anti -acid agents need to be used with iron agents.

3. Eat more fresh fruits or juice such as citrus and kiwi rich in vitamin C. These can increase the absorption of iron.

Review expert: Li Yongmei Luo Luo, Department of Pharmacy, Fifth Hospital Affiliated to Guangzhou Medical University

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