GHID din 9 august 2019 privind anemia feriprivă la gravidă

Anemia with pregnancy

E-mail: moc. This article has been cited by other articles in PMC. Abstract AIM: Our study aims to make a comparison between the effects of milking of umbilical cord versus delayed cord clamping on Hemoglobin level at 6 weeks from delivery among term neonates and which method is more beneficial for them.

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Participants were randomised into 2 groups; Group 1: women were assigned to delay cord clamping; Group 2: women were assigned to milking of the umbilical cord 5 times before cutting. Anemia with pregnancy t-test was used to compare between the two groups for quantitative data, for qualitative data chi-square test and the Correlation coefficient was done to test the association between variables. Cairo, Egypt. RESULTS: In this study, we found that milking of the umbilical cord five times as in group 1 was associated with higher hemoglobin levels at 6 weeks after birth, at physiological anemia of the fetus and significant but clinically there was no difference between the two groups For most other outcomes including APGAR score, positive pressure ventilation, poor neonatal outcomes such as respiratory distress syndrome there were no significant differences between the two groups.

Our study may recommend the use of umbilical cord milking in term babies when delayed cord clamping is unavailable.

Pregnancy and Delivery

Keywords: Delayed cord clamping, Umbilical cord milking, Neonatal physiologic anaemia, Term newborn Introduction The umbilical cord is the essential life-keeping connection between fetus and placenta. It represents a strong connection to the fetomaternal interface while permitting fetal mobility that is essential for general fetal development and neuro-motor development in particular [ anemia with pregnancy ]. When a baby is born, the umbilical cord is cut, and there is a stump left which should dry and fall off by the time of 5 to 15 days after birth [ 2 ].

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Delayed cord clamping, which was adopted by American Academy of Pediatrics in all deliveries, is defined as ligation of the umbilical cord minutes after birth or on stoppage of cord pulsations, will lead to a huge amount of blood transfused from the placenta than cord clamping done promptly after delivery [ 3 ] [ 4 ]. However, delayed cord clamping may not be possible, as it could be forgotten by obstetrician or cord may have to be clamped promptly in case of fetal distress or complications at birth [ 5 ].

Pregnancy and Delivery

In such cases, we perform umbilical anemia with pregnancy milking to transfer the extra blood to decrease blood transfusions and augment haemoglobin in both preterm and term infants. Both umbilical cord milking anemia with pregnancy delayed cord clamping have been related to high iron stores in neonates [ 6 ], but it may strongly affect the cerebral blood flow dynamics [ 4 ].

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anemia with pregnancy Delayed cord clamping, in which we clamp the cord after 30 to seconds of birth, permits the transfer of blood from placenta to the newborn, makes the hematological values and iron stores in both preterm [ 7 ] and term infants better [ 8 ] [ 9 ], decreases anemia, decreases the need for blood transfusion, improves cerebral oxygenation in earlier born babies [ 10 ] and provides considerable amount of placental stem cells to the baby without causing any adverse effects to the mother [ 11 ] [ 12 ].

A previous study has shown that there is a transfer of about 80ml of blood from the placenta at 1 minute after birth, reaching about ml at 3 minutes after birth. Stabilization of the circulatory system of the neonate during the first 24 hours of life occurs if we delay cord clamping for minimum 30 seconds, leading to less need for volume therapy, transfusion and inotropic support, decreases the need for given cell transfusions, decreases the occurrence of intraventricular hemorrhage and improves neuro-developmental outcome [ 13 ].

Early Versus Delayed Umbilical Cord Clamping on Physiologic Anemia of the Term Newborn Infant

Although apparent benefits in cord clamping after delivery seconds, it can prevent neonatal resuscitation. So, the delay in clamping of the cord is not preferred in extremely low birth weight newborns [ 14 ]. Recent studies have found that umbilical cord milking also leads to significant increase in haemoglobin in both premature [ 15 ] [ 16 ] and term infants with milking being performed either with clamped [ 6 ] or unclamped umbilical cord [ 17 ].

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At the age of anemia with pregnancy months, high body iron stores were found in delayed-clamped babies anemia with pregnancy comparison to early-clamped infants by about 27 mg of iron. Delayed cord kidney cancer renal vein involvement in newborn found to decrease blood values of lead, because of improved iron status during infancy [ 18 ].

Delayed cord clamping was found to be related to some adverse reactions; it may augment rates of hyperbilirubinemia, polycythemia, and transient tachypnea in the neonate but, has never been proven to increase the rate of symptomatic neonatal disease or blood loss in mothers [ 19 ]. All healthy newborns show a drop in red blood cells values during the first weeks anemia with pregnancy life which is due to multiple physiological factors.

In sick preterm infants, it occurs due to several additional predisposing causes; the most important of them is phlebotomy which is blood loss for the sake of laboratory testing.

For this reason, because the marked decrease in haemoglobin concentration that found in many extremely low birth weight neonates is usually seen with abnormal clinical signs and need for allogeneic red blood cell transfusions [ 21 ].

Iatrogenic anaemia caused by multiple blood sampling for laboratory investigations is not uncommon and with no symptoms in babies who were born prematurely. We should record the amount anemia with pregnancy the collected blood to prevent any unwanted iatrogenic losing of blood.

Chronic losing of blood and moderate haemorrhage usually is asymptomatic in babies except for some pallor.

How Will I Know if I’m Low in Iron?

The target was to increase the life of cells in vivo and decrease the risk of anemia with pregnancy and acidosis. At approximately 15 milliliters per kilogram body weight, tiny babies require relatively small volumes of blood per transfusion [ 22 ]. Also; an erythropoietin is sometimes needed to limit red blood cell transfusion where the initial r-erythropoietin trials in very low birth weight infants demonstrated that administration of the drug resulted in reticulocytosis with an increase in hematocrit.

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Furthermore, most r-erythropoietin-exposed infants received fewer and lower volumes of red blood cell transfusion during the study period. This finding was strongest in stable, growing preterm infants, most of whom had received multiple blood transfusions prior to study entry [ 23 ]. The mothers were pregnant women at or above 37 weeks of gestation, with a single baby, free of other anemia with pregnancy disorder Diabetes-hypertension-cardiac problems-renal, hepatic, etc.

Anemia with pregnancy informed consent was obtained from the parents and was included in the medical record. Each woman was subjected to the following: - General examination: pulse, blood pressure and temperature. Fetal measurements include biparietal diameter, head circumference and femur length. Neonatal haemoglobin measurement A sample of cord blood was taken immediately after delivery of haemoglobin by Easy Touch GCHb device.

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Minimal sample volume for haemoglobin analysis: 2. Quantitative data were expressed as the mean± standard deviation SD. Qualitative data were expressed as frequency and percentage.

Relationship between anemia and spontaneous preterm birth

Non parametric data was represented by median and range. Data were analysed to test the statistically significant difference between groups. For quantitative data mean ± SDstudent t-test was used to compare between 2 groups. For qualitative data frequency and proportionthe chi-square test was used.

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The correlation coefficient was done to test the association between variables. Based on the previous study; comparing early versus delayed clamping of the cord and comparing early clamping versus milking of the cord [ 19 ], the expected effect size is 0.

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Cancer cerebral nivel 3 an alpha level of 0. Two cases will be added to each group to guard against fallacies in laboratory measurements. Thus, each group will include women delivering a singleton fetus at term vaginally.

Anemia (Anaemia) in Pregnancy, How I am dealing with it!

A total of pregnant women were included in the current study. The demographic and obstetric characteristics of the study population are shown in Table 1.