Normal haematological changes of pregnancy and how to handle them

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A normal pregnancy is often characterized by extensive changes in most organ systems so as to keep up with the demands of the fetoplacental unit in the body. For this reason, the haematological system must undergo a number of adaptive changes, for instance, provision of minerals and vitamins for fetal haematopoiesis as well as to prepare for the blood loss that’s naturally expected during delivery. These changes can start immediately after conception, through to the pregnancy, delivery, and even after the postpartum period. Some of the normal haematological changes of pregnancy include:

Physiologic Anemia

Physiologic anemia, also known as dilutional anemia, is caused by a higher ratio of plasma volume to the red blood cell. This condition can appear between the 2nd and 3rd trimester, with its peak being at 30-34weeks GA. The presence of this condition offers benefits related to decreased blood velocity, whereas its absence may increase the tendency for stillbirths.

Leukocyte and Immunological Function

Leukocytosis, together with a higher level in the neutrophils is common towards the end of the first trimester, usually the second month, with an increase in these conditions observed over the course of the pregnancy. Leukocyte levels are associated with the cervical dilation as well as the progress of labor; therefore, they should be resolved a week or less after postpartum

Mild Thrombocytopenia

Mild thrombocytopenia, defined as a low blood platelet count, occurs in the third trimester but should be resolved postpartum. Even though a decrease in platelet count is normal during pregnancy, it’s important to distinguish between gestational thrombocytopenia and other causes of thrombocytopenia, which could be part of a more complex disorder, for instance, severe preeclampsia, immune thrombocytopenia, drug-induced thrombocytopenia, and much more.

Coagulation and Fibrinolysis

The coagulation cascade is often in an inactivated state. However, pregnancy is considered a procoagulant state. This means that pregnancy causes the fibrinogen levels to increase, averaging about 450mg/dl. Generally, the coagulation profile change significantly prevents postpartum hemorrhage.

Being familiar with these normal haematological changes of pregnancy encourages an optimal management of pregnancies. Plus, you can handle them by following these two steps:

Visit a Haematologist

Even though these haematological changes are normal during pregnancies, occasionally, they can be part of a more complex disorder. Plus, women with prior haematologic (blood) conditions tend to face unique challenges during pregnancy. This is because pregnancy increases the risk of blood clotting while delivery increases chances of hemorrhage. It’s imperative for pregnant women to visit a haematologist to help diagnose and clinically manage blood and bone marrow disorders. Haematology jobs also include providing clinical support, including the blood bank.

Iron Supplementation May be needed

Healthy pregnancies come with a significant decrease in hemoglobin levels, which is associated with a greater expansion ratio of plasma volume to the red blood cell. Pregnant women are more susceptible to iron-deficiency anemia since they lack adequate iron stores to cater to the demands of the pregnancy. But, with iron supplementation in pregnancy, pregnant women can increase their mean hemoglobin level.


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