ANAEMIA IN PREGNANCY

(A CASE STUDY OF PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT UNIVERSITY OF NIGERIA TEACHING HOSPITAL. (UNTH, ENUGU)

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LIST OF TABLES
Pages
TABLE 1: Distribution of pregnant Women by age 34

TABLE 2: Calculation of the mean of age distribution 34
TABLE 3: distribution of patients according to their
occupation 36

TABLE 4: Distribution of patient according to their
educational level 37

TABLE 5: Distribution of patients according to severity 39
TABLE 6: Distribution of patients according to gestational age 41

TABLE 7: Distribution of calls according to associated
Conditions 42

TABLE 8: Relation of incidence of anaemia in
pregnancy outline of patients 42

TABLE 9: Relation of the incidence of anaemia in
pregnancy to outline of baby 42-43

TABLE 10: Relation of incidence of anaemia in pregnancy
to birth weight of baby 43

TABLE 11: Result of PCV, Hb and ESR test at
University of Nigeria Teaching Hospital (UNTH) Enugu

Plate 1: practical demonstration with haematocrit centrifuge 62

Plate 2: Blood samples and ESR set-up 62

ABSTRACT

The study on anaemia in pregnancy is aimed at determining packed cell volume (PCV), Haemoglobin (Hb) level and Erythrocyte sedimentation rate (ESR) of pregnant women, as well as the selferity, significance of maternal, age, educational level, occupation and gestational age to the occurrence of anaemia in pregnancy managed, diagnosed and admitted at the university of Nigeria teaching Hospital (UNTH) Enugu. The result showed that most of the patient had moderate to secure anaemia and that the cases were commonest in the age range 25-29 years. Most of the patient were housewives and low level civil servants who lived in middle and lower class residential area ad who had no formal education. Anaemia in pregnancy was seen to occur most commonly in the third trimester. It occurred all through the year, but mostly in the wet season and had the greatest positive association with malaria and nutritional deficiency. Anaemia in pregnancy was seen not to be rampant in our today’s society due to the small number that tested positive Anaemia in pregnancy was also seen not to have any effect on birth weight of babies.

TABLE OF CONTENTS.

CHAPTER ONE
Introduction
Epidemology
Classification
Types of Anaemia
Pathophysiology
Aims and Objectives
Statement of Problems
Limitations/Scope
CHAPTER TWO
Literature Review
Hereditary Spherocytosis
Glucose – 6 – Phosphate
Ineffective Condition

CHAPTER THREE
Materials and method
Collection of Samples
Sterilization
Determination of Packed cell volume
Determination of Haemoglobin (Hb)
Determination of Erythrocyte
Sedimentation rate (ESR)
Determining the significance of age, Educational level, etc
Method of Data collection
Method of data Analysis
CHAPTER FOUR
Results
Distribution of pregnant women
Distribution of patients according to their occupation
Distribution of patients according to their educational level
Distribution of patients according to severity.

CHAPTER FIVE
Discussion
Distribution
Distribution pregnant women by age
Percentage of Anaemia in pregnancy etc.

CHAPTER SIX
Conclusion / Recommendations
Action by the Government etc.
References
Appendix
CHAPTER ONE

INTRODUCTION
DEFINITION: The world health organisation (WHO) index for anaemia in pregnance is when the haemoglobin level in the peripheral blood is Hg/dl or less. However, from practical experience in tropical obstetrics it is generally accepted that anaemia in pregnancy Exist when the Haemoglobin level is less than in loglde or the packed cell volume less than 30%

EPIDEMOOGY:
Anaemia in pregnancy presents a world-wide problem but it is uncommon in developed world. the importance of anaemia in pregnancy in the tropics lies firstly in its greatly increased incidence, and secondly in the seventy of the anaemia with which the patients commonly present for treatment. Both combine to make this complication of pregnancy a major cause of matanal and fetal death in the tropics. A third important problem posed by anaemia in the tropics is polymorphism. In almost all cales, the anaemia is caused by multiple factors whole individual importance varies from area to area. This makes rational prophylaxis and treatment much more difficult. Complicaion of pregnancy in the for at belt of West Africa, between January and April 1955. it was directly responsible for more than 20% of all matanal deaths in patients under the car of the Department of obstetrics, university college Hospital, Ibadan. It also contributed to many other deaths from Antepartum haemorrhage, postpartum haemorrhage and puerperal sepsis. In Nigeria it is a frequent complication, its incidence is high and its severity is staggering. The clinical feathers of anaemia in pregnancy in Nigeira are different from those encountered in temperate countries not only because of the severity of symptoms but also because of the concomitant autuminosis such as marked glossitis, Angular stomatitis and associated gross hepatomegly. Agbola A. (1991)

CLASSIFICATION
Anaemia in pregnancy could be mild, moderate or severe based on the haemoglobin level in the peripheral blood as well as the clinical manifestations and the management would differ for each.

TYPES OF ANAEMIA HB LEVEL
Mild Anaemia in pregnancy 9-Hg/dl
Moderate Anaemia in pregnancy 7-9g/dl
Severe Anaemia in pregnancy 7g/dl

PATHOPHYSIOLOGY
For haemoglobin and Red blood cell synthesis, iron, folate, vitamin Biz and Vitamin c, trace elements like cobate and copper, and proteins are required. Erythroporetin produced by the renal parenchyma stimulates the bone marrow to increase erthropesis which is one of the noticeable physiological changes in pregnancy. Barnes, F.C (1994).
In the non-pregnant female, the total body is about 3.5-kg. 2/3 of this is Haemoglobin another ¼ is in the body stores and the remaining is in the tissue and plasma. Iron is stored in the liver and spleen as femitin and in bone marrows haemosiderin. Iron in the serum is bound to transfer in, a B1 – globulin and transfers is only 1/3 saturated with iron.

A good diet provides about 10-15mg of iron per a day and only 10% of this is absorbed. Iron is mainly absorbed in the duedenuim and to some extent in the upper jejunum. The absorption is influenced by dietary phosphates, phytaces, ascorbic acid, sugars especially frutole, Hell in the stomach and gastric factors namely factors I, II and II, iron is lost in the bile, urine, fences, sweat and during menstruation. About 1-2mg of iron is lost dail…

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