Anaemia

When there is a deficiency of red blood cells or of haemoglobin in the blood.

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Iron-deficiency during pregnancy

Anaemia refers to a deficiency of iron in your body. Iron helps produce haemoglobin which helps the red blood cells to store and carry oxygen in the body. Anaemia may also refer to a deficiency of folic acid or Vitamin B12 or a combination of the two. About 6 out of 10 pregnant women in India are anaemic. It’s important to manage anaemia during pregnancy because it has health implications for both you and the baby. Who is at risk of anaemia? The following groups of women have a higher risk of anaemia than others. Women who have a diet which is low in iron-rich foods. Women who have severe morning sickness (hyperemesis gravidarum) and can’t keep down any food. Women who have had anaemia in an earlier pregnancy. Women who had heavy periods before pregnancy. Women who are pregnant at 20 years or younger. Women who are carrying twins or multiples. Why is anaemia harmful during pregnancy? Anaemia first affects you and then your baby. Here are some of the complications that result from anaemia. Fatigue and low energy levels Pre-term labour Low birth-weight baby Baby born with low iron levels Higher risk of contracting an infection when pregnant Symptoms and diagnosis of anaemia Symptoms of anaemia include tiredness, irritability, low energy levels, breathlessness, weakness, dizziness, pale eyelids and nail beds, a sore tongue and strange taste in the mouth, hair loss, headaches, unusual cravings and low tolerance for the cold. Most of these symptoms can be attributed to other factors during pregnancy which is why most women do not realize they are anaemic. The best way to detect anaemia is through a blood test early on in the pregnancy. You are diagnosed as anaemic if your haemoglobin is lower than 11g/dL of blood. How is anaemia treated? While women usually require 30mg of Iron in a day, this becomes 38mg during pregnancy. Most pregnant women are given one iron tablet(100mg of elemental iron and 0.5mg folic acid) a day to prevent anaemia. This is given for 100 days starting in the second trimester of the pregnancy. For women who are diagnosed as anaemic, this is increased to two tablets a day, one in the morning and one in the evening. This will continue until the haemoglobin levels become normal after which they can switch to one tablet a day. The iron supplements should not be had together with calcium supplements as calcium hinders proper absorption of iron by the body. Vitamin C on the other hand aids in iron absorption. Therefore, you should avoid having calcium-rich foods like milk for an hour after having the iron tablet. Instead, you should have Vitamin C rich fluids like orange juice, gooseberry (amla) juice, and lemonade. In extreme cases, the doctor may have to give an intravenous injection or even a blood transfusion to make sure the body gets enough iron. Eating iron-rich foods is a must during pregnancy. The body absorbs iron better from non-vegetarian sources of food than vegetarian sources. Thus, vegetarians should make sure they have more iron-rich food.  

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Potential complications of twin pregnancy

So, are you going to welcome double happiness? Congratulations on the twins! If double blessings are on your way and you are worried about the complications in your pregnancy, then it’s time for you to relax and educate yourself with all the possible twin pregnancy complications with this easy-to-understand guide- Common Complications Associated with Twin Pregnancy 1. Preterm labor When the delivery happens before 37 completed weeks of pregnancy, it is called as preterm delivery. When you carry an additional fetus in your womb, the gestation period decreases. The premature rupture of the ovarian membranes results in preterm labor.   Premature babies do not develop properly. They do not achieve a normal healthy weight before they are born. Low-birth-weight babies may be incapable of fighting infections. These babies often need special care in a NICU.   2. Miscarriage risks As compared to singletons, a twin pregnancy carries a higher risk of facing a miscarriage. But it is impossible to say how much higher the risk is, as most early miscarriages are not identified. Most of the miscarriages occur in the first trimester of the pregnancy. Sometimes one baby is lost but it does not have an adverse effect on the development of the second baby. Many early twin pregnancies are not discovered so this occurrence is more common in nature. Feeling sad and down is natural under these circumstances. But you do not have any control over it. Talk to your doctor to guide and support you better during this difficult time. 3. Intrauterine Growth Restriction (IUGR) One of the most common complications with a twin pregnancy is the growth issue. The growth rate of the twins begins to slow down at 29 to 32 weeks. IUGR occurs during the same phase when placenta cannot handle any more growth of the twins. IUGR is a condition in which a baby is smaller than is expected to be. Your body starts succumbing to the growth process as both the babies compete to obtain a sufficient amount of nutrients. Contact your gynecologist, as she may guide you by performing an ultrasound and measuring the size of your abdomen. 4. Placental Abruption If the placenta detaches itself from the uterine wall before the time of delivery, it may lead to serious complications. Though it affects only 1 % of pregnant women, but chances of this condition are higher in twin pregnancies. In the case of a twin pregnancy, abruption may occur just after the first baby is delivered vaginally. Usually, C-section is advised to deliver the other baby. 5. Preeclampsia and High blood pressure The chances of developing Preeclampsia are higher when you are expecting twins. High blood pressure can also be one of the complications that can pose serious threats to you and the unborn babies. Preeclampsia is a pregnancy complication marked by protein in the urine, high blood pressure, liver or kidney abnormalities. But with adequate parental care, it is possible to reduce the risk of developing a serious problem from preeclampsia. 6. Anemia Due to increased blood flow, iron level drops which cause anemia. Your doctor will prescribe you a suitable iron supplement to cope up with this condition. When you are suffering from anemia, your body feels drained and tired. This complication is more common in multiple pregnancies. Regular checkups are must to keep a track of anemia levels. 7. Heart Failure It is also observed that 13% of the women who are expecting twin pregnancies suffer from the danger of heart failure. They are more likely to have the risk of heart failure as compared to a singleton. 8. Gestational Diabetes This is one of the most common problems that occur in twin pregnancies. The resistance to insulin production increases due to the presence of two placentas. And it leads to a sudden increase in blood sugar level. Greater placenta size or elevated levels of the placental hormones are also some of the reasons that lead to gestational diabetes. 9. Birth Defects Twin pregnancies can also have the risk of developing congenital abnormalities in the newborn twins. Heart abnormalities, gastrointestinal disorders, and neural tube defects are some of the common birth defects usually experienced in case of twin pregnancy. 10. Obstetric Cholestasis This rare condition affects the liver. Many studies have revealed that Obstetric cholestasis is caused by pregnancy hormones estrogen and progesterone. Twin or multiple pregnancies produce a higher level of hormones that why it is more common in such kind of pregnancies. The most common symptom is extreme itching without rashes. Contact your doctor immediately if you experience something like this. Prevention of complications This is the most common question that people often have and we truly understand this. Twin pregnancies have little to do with your lifestyle or behavior. But an early confirmation that you are expecting twins may help you in a big way. This will help your doctor to detect, monitor or treat complications that may arise. It is highly recommended to make a note of these important points- Mothers who carry more than 1 fetus need more proteins, calories, iron, and nutrients. So, you need to have a healthy diet. Proper hydration is highly recommended.  Be aware of all the warning signs associated with pre-eclampsia and other pregnancy complications that need immediate attention More frequent prenatal visits help the doctor to monitor and treat the condition timely and effectively. Seek doctor’s advice on doing some gentle exercises during your pregnancy and also attend all antenatal appointments. Smoking is injurious to health and it is deadly during pregnancy. If you really want to do something for your babies, quit this bad habit now! Passive smoking may also create problems so ask your family members and visitors to smoke outside and make your home a smoke free zone. Feature Image Source

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