oa South African Medical Journal - Anaemia in obstetrics
1. A survey of haemoglobin levels in pregnant women has been made, the results tabulated and compared with those found in the literature. Severe anaemia is uncommon in the United Kingdom. A pattern of investigation similar to this can be followed in South Africa, especially in the various strata of society and the necessary preventive measures carried out. 2. Physiological and pathological naemias have been differentiated, and the latter classified according to aetiology, as a more exact guide to treatment. The attitude that most cases of anaemia are physiological and that all cases will improve after delivery, is to be deprecated. 3. The effect of age, multiparity and social conditions on anaemia has been recorded. 4. Mild anaemia does not produce any marked effect on the course of pregnancy and labour, but the incidence of puerperal pyrexia is increased. With severe anaemia (haemoglobin less than 50%), the maternal morbidity and mortality rate is raised, but can be minimized by modern methods of treatment and in this respect blood transfusion is life-saving. 5. Haemoglobin estimations should be carried out at all antenatal clinics, and iron therapy administered in cases below 80%. Failure of response to treatment demands full blood investigation. 6. Treatment has been aided by the knowledge of factors influencing absorption and utilization of iron, and the realization of the value of protein concentrates, autolyzed yeast, and an adequate diet with sufficient vitamins. Macrocytic anaemia is more easily recognized by improved methods. The fact that cases of macrocytic megaloblastic anaemia. while refractory to treatment by parenteral liver, respond to peroral proteolyzed liver and folic acid, has opened up a new field of investigation on enzyme action, haemopoietic factors, selective absorption and utilization.
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