Screening/Diagnosis:             

 

All patients should be evaluated for anemia both historically and by laboratory assessment on the first prenatal visit. Pregnant women are at a higher risk for iron deficiency anemia because of the increased iron requirements of pregnancy. In pregnant women hemoglobin (Hb) or Hematocrit (Hct) levels drop during the first and second trimester because of blood volume expansion. Hb is a more sensitive marker. Iron-deficiency anemia during the first two trimesters of pregnancy is associated with a twofold increased risk for preterm delivery and a threefold increased risk for delivering a low-birth weight baby. Longitudinal studies have shown that the highest prevalence of anemia during pregnancy is in the third trimester.  Patients with a hematocrit less than 34% or hemoglobin less than 12 gm % at any point in the pregnancy should be considered anemic.

 

 

 

If this cannot be accomplished at the clinic, the patient should be referred to the Duke High Risk OB Clinic.

 

 

Prepared in conjunction with the

Division of Maternal-Fetal Medicine

Duke University Medical Center

 

                                                                                                                                    Director 

                                                                      6/20/08                                                              Date 

 

                                                                

The Clinical Care Guidelines Development Committee of the Perinatal Improvement Board of Duke University Health System has developed a series of multi-disciplinary protocols to offer guidance to health care providers who are caring for pregnant women with high risk conditions.

 

These protocols are designed to assist health care providers in the management of a variety of problems that occur in pregnancy and the time of delivery. They should not be interpreted as standard of care, but instead represent only general guidelines for the care of pregnant women with high risk conditions.  We recognize that services offered by individual providers depend not only on their training, experience and institutional resources, but on the medical facts and circumstances of the specific care situation.

The protocols remain the intellectual property of the Duke University Health System.  They cannot be reproduced in whole or part without the expressed permission of the Health System.

 

These protocols are reviewed by the Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine, the Department of Pediatrics Division of Neonatology and the Department of Anesthesiology Division of Women’s Anesthesia.  Please contact Andra H. James (andra.james@duke.edu), Chair, Clinical Care Guidelines Development Committee of the Perinatal Improvement Board with ideas for additional protocols.