Anemia in Pregnancy : Risk Factors to Comprehensive Management.

Abstract

Background:
Anemia in pregnancy remains a major contributor to maternal and perinatal morbidity, particularly in low- and middle-income settings. In late gestation, even mild anemia may become clinically important because maternal hematologic reserve is reduced at a time when delivery-related blood loss and operative intervention may be imminent. This report highlights the importance of diagnosing third trimester anemia in a patient with additional obstetric risk factors.
Case Report:
A 36-year-old multigravida woman (G3P2) at 36–37 weeks of gestation was admitted with third trimester anemia, persistent oblique lie, a short interpregnancy interval, and a history of two previous cesarean deliveries. On admission, she was hemodynamically stable, and cardiotocography showed a reassuring category I fetal heart rate pattern. Laboratory evaluation demonstrated mild anemia, with
hemoglobin 10.4 g/dL and hematocrit 33%. Because of persistent malpresentation in the context of two prior cesarean sections and near-term pregnancy a repeat cesarean delivery was planned The postoperative course was favorable. Hemoglobin remained at 10.1 g/dL after surgery and 10.0 g/dL on postoperative day 1. There was no evidence of hemorrhagic complications or need for blood
transfusion. Uterine involution was found to be adequate and maternal recovery was satisfactory. Patient was discharged in stable condition.
Conclusion:
This case underscores that even mild third-trimester anemia warrants careful evaluation when combined with advanced maternal age, multiparity, short interpregnancy interval and anticipated operative delivery. Timely admission, close maternal as well as fetal monitoring and close postoperative surveillance can support favorable outcomes while minimizing the risks associated with antepartum anemia