Learing objective 4

Iron deficiency and malnutrition in

pregnant
A. Definition
Lack of red blood cells (hemoglobin) in blood caused by
iron deficiency
• WHO : Anemia in pregnancy if:
- Hb rate <11 g / dL (in trimester I and III)
- Hb rate <10.5 g / dl (in the second trimester)

B. Epidemiology
• 37.1% of pregnant women suffer from anemia (Riskesdas
2013)
-36.4% in urban areas
-37.8% in rural areas
• 30-50% of women suffer from anemia in pregnancy, with
iron deficiency as the most common cause, namely more
of 90% of cases
C. Pathophysiology
 Different iron requirements for each trimester Iron
requirements increase rapidly in the second and
third trimesters due to fetal growth, and there is a
significant increase in plasma volume.
 Iron requirements are 1000 mg: consisting of
maternal needs of 500 mg for red blood cell
expansion, 300 mg for fetal needs and 200 mg of iron
lost through the intestine, urine and skin
 Iron deficiency can be triggered due to increased
intakes, increased absorption and iron loss
D. Etiology
1. Food does not contain enough IRON
2. Absorption interference
3. chronic bleeding (iron loss )
4. increased intakes
E. Supporting Examinations ( Pemeriksaan Penunjang )
• Low Hb and Ht
• MCV, MCH, and low MCHC (microcytic
hypochrome)
• Peripheral blood smear preparations (microcytic
hypochrome)
• Ferritin decreases, SI decreases, and TIBC
increases
F. Management (Tatalaksana)
• General Management - ± 200 mg of elemental iron per day -
When in 90 days there is improvement, continue giving tablets
up to 42 days postpartum
• Special Treatment for transfusion for anemia is performed in
patients with the following conditions:
• Hb level <7 g / dl or levels hematocrit <20%
• Hb level of 7-10 g / dl with clinical symptoms: dizziness,
dizziness, or tachycardia (pulse frequency> 100x per minute)
G. Prognosis
• Complications -In infants / children
- Iron deficiency in the first 3 months of life
- Decrease in mental and psychomotor conditions
- Poor emotional control
• In Mother
- Preterm birth
- LBW (BBLR )
- Plasma solution
- Increased risk of post partum hemorrhage

DAFTAR PUSTAKA
1.Cunningham FG, dkk. Williams Obstetric, ed. 23.New York: McGraw-Hill; 2010.
2.Kementerian Kesehatan Republik Indonesia. Buku Saku Pelayanan Kesehatan Ibu di
Fasilitas Kesehatan Dasar dan Rujukan, edisi 1 Jakarta; 2013.
3. Gambar diunduh dari http://www.nhs.uk/Conditions/nail
abnormalities/PublishingImages/M1900072_spooned-nails_342x198.jpg