Low hematocrit in the blood during pregnancy

What are red blood cells

The state of the body in pregnant women, compared to girls who are not carrying a child, undergoes serious changes.
This also applies to quantitative indicators of red blood cells. The rate of red blood cells in the blood, with such changes, increases by about a quarter. If pregnancy proceeds normally, blood plasma levels also become elevated. At the same time, the level of hematocrit and hemoglobin concentration decreases. Often, if the level is too low, pregnant women are faced with hemodilution anemia, which has some differences compared to iron deficiency.

It is generally accepted that a normal red blood cell count during pregnancy is a level of more than 3.5*1012/l. In addition to the direct transport function, red blood cells are engaged in nutritional and protective work. The formation of these blood cells is carried out in the bone marrow.

From there they are sent into the bloodstream, where they circulate freely. Due to the fact that the substance produces constant production, its quantity on average remains unchanged.

Red blood cells are detected by the simplest test. We are talking about a general clinical blood test. They demonstrate the percentage ratio of plasma volume in the blood to all other components. In addition, this value can be measured in other units mentioned above. Due to the gradual increase in the total blood volume, a change in the norm occurs, depending on the period.

The analysis determines not only the number of red blood cells, but also their sedimentation rate. During pregnancy, the indicator may decrease to 3.5 * 1012/l due to the increasing volume of blood in general. The body begins to prepare for subsequent blood loss, which is inevitable during childbirth.

At the same time, the plasma volume also increases. Its level reaches 35-50 percent, red blood cells in this case make up 12-25 percent. Depending on the stage of pregnancy, their norm varies. Thus, in the first trimester the highest indicator is 4.2-4.5*1012/l, for the second trimester 3.5-4.8*1012/l is considered the norm, for the third 3.7-5*1012/l

It is important to emphasize that the presence of severe toxicosis increases the number of red blood cells

What should the diet be like?

When switching to enhanced nutrition, a pregnant woman needs to remember that iron absorption occurs faster if it is combined with sufficient intake of vitamin C. The diet includes:

eggs;
nuts;
fruits and desserts made from fresh fruits with sourness (this can be apples, citruses, pomegranate, kiwi);
liver;
liver and offal;
Brut dark chocolate in limited quantities;
pharmaceutical Hematogen.

Fatty and fried, spicy and seasoned foods, soda, and fast food are excluded from the diet.

Here are the nutritional tips Dr. Komarovsky gives:

What is hematocrit value

A doctor’s most important tool in determining a patient’s condition is laboratory diagnostics. The body of the expectant mother is completely rebuilt during pregnancy. Everything changes - hormonal, water, salt balances. The composition of the blood changes completely. These changes must be monitored for the benefit of the health of the woman and her unborn child, for which it is necessary to periodically take blood tests.

Control will allow timely prevention of the development of unwanted, painful conditions and pathologies. The patient's condition is assessed by considering the percentage of the constituent parts of the blood - formed matter (platelets, leukocytes, erythrocytes) to the intercellular fluid (plasma).

The general indicator obtained as the final result of such an analysis is called hematocrit or otherwise - hematocrit number, hematocrit value. The purpose of this indicator is to measure the ability of blood to carry oxygen. In its most general sense, the hematocrit number indicates the volume of red blood cells in the blood. The indicator does not reflect data on the shape, size and hemoglobin content of red blood cells.

Determining the hematocrit value is not part of a routine blood test; it is done on the special orders of the attending physician. In laboratory records it is referred to by the Latin abbreviation Ht or HCT. Hematocrit norms vary among different age groups and genders. The hematocrit number in pregnant women, as well as in women during menstruation, has its own special indicators that differ from the general values.

The norm for hematocrit in women is 0.36-0.46 (360-460 million cells in 1 liter of blood), the norm in men is 0.4-0.48. The norm in newborns is 20% higher, and the norm in young children is 10% lower than in adults. After 65 years, there is a non-significant decrease in hematocrit by 3-5% from the values observed between the ages of 20 and 65 years.

Hematocrit norms for pregnant women

The normal hematocrit number during pregnancy is 33-40%. In a woman under normal conditions, this value ranges from 36 to 46%. Thus, we can make a preliminary conclusion that hematocrit norms in a pregnant woman are 3-6% lower. The volume, weight and size of the fetus affects hematocrit values. The larger the fetus, the greater the ratio of plasma to formed matter. In late pregnancy, the hematocrit number is 30-31%. Shortly before birth, the hematocrit value stabilizes and becomes slightly higher - about 33%.

If we display the values by trimester of pregnancy, we get:

First trimester – 33-40%;
Second trimester – 30-31%;
Third trimester – 33%.

During normal pregnancy, the hematocrit decreases. If it does not change or the values of the variables are negligible, this is an alarming signal indicating that pathological changes may have begun in the body of the expectant mother. A hematocrit below the lowest normal threshold may indicate the development of anemia in the patient.

General information

The hematocrit number shows what proportion of the total blood volume is occupied by formed elements. This indicator is written as a percentage or decimal fraction. For a more accurate analysis, not all blood cells are taken into account in the numerator, but only red blood cells, although the difference will not be so significant, because they already make up 99% of the formed elements. It should also be noted that, in addition to the number of cells themselves, the hematocrit level is affected by their volume (size).

In a general analysis, hematocrit, along with the concentration of red blood cells and the level of hemoglobin in them, reflects the gas transport function of the blood, i.e. its ability to carry oxygen. This indicator is determined quite simply - after centrifugation in a graduated glass capillary, it is noted which part is allocated to the formed elements. But modern laboratories are increasingly using automatic analyzers.

An organism in a physiological state has a relatively constant level of formed elements and plasma. It is known that blood volume averages 7% of body weight and 55% consists of the liquid part (plasma). And cells - red blood cells, white blood cells and platelets - occupy the remaining part. In men, the hematocrit number is 0.4–0.48, and for women the normal value is slightly lower: 0.36–0.42.

What is hematocrit during pregnancy?

Hematocrit is an indicator that is not detected by a general blood test. It indicates the total volume of red blood cells in the blood. It can only be detected with a doctor's prescription. It fits into the analysis form as a percentage.

Hematocrit is determined from any blood - arterial, capillary and venous. To get an accurate indicator, you need to prepare for a blood test:

In no case should you smoke before the procedure, so as not to reduce vasospasm, as a result of which blood may flow slowly.
It is also undesirable to eat anything before the analysis, but breakfast is allowed as long as it does not contain fat.
Naturally, you cannot drink alcohol.
Avoid physical work before taking the test.
Try to avoid stress before analysis, because it may affect the indicators (they will be incorrect).

The collected blood is drawn into a glass tube with 100 lines on it, after which it is transferred to a centrifuge, in which it remains for 1-2 hours. After this, the laboratory technician determines the level of separated and settled red blood cells and compares it with the level of plasma and blood as a percentage.

The data obtained will become the basis for diagnosing anemia, assessing the results of the completed course of treatment, determining the level of blood viscosity and the need for blood transfusion.

To understand whether the hematocrit level in the blood is low or normal, it is not necessary to undergo a special test. You can understand this by the corresponding symptoms and signs:

frequent headaches with dizziness occur;
a person gets tired quickly, despite the fact that he works little;
general condition is lethargic and weak;
there is practically no performance;
the skin becomes dry and pale;
heart rate becomes rapid;
shortness of breath appears and blood pressure levels rise;
hair and nails break.

All these symptoms are extremely undesirable for an expectant mother to experience. Therefore, as soon as they appear, you must inform your doctor about this.

Reasons for changes in red blood cell count

In the case where the actual content of blood cells deviates significantly from the norm of red blood cells in the blood, the reason due to which this failure occurred should be identified. The significance of this pathology cannot be underestimated, since it can negatively affect the supply of oxygen to the fetus, which is necessary for the proper development and functioning of all body systems.

With a high level of red blood cells in the blood, pregnant women run the risk of insufficient oxygen supply to the baby. This happens due to blood thickening, which is why already oxidized compounds reach the child.

Causes of high blood cell counts:

dehydration of the mother’s body as a result of severe toxicosis;
pathologies of the cardiovascular system and kidneys;
prolonged hypoxia;
constant increase in temperature.

A more common situation is when red blood cells are low during pregnancy. A low level of blood cells with a significant deviation from the norm is considered a serious pathology and requires identifying its causes.

If the content of red blood cells in the blood is increased or decreased in the initial stages of pregnancy, this can provoke deviations in the development of the internal organs of the fetus. In the last trimester, a low level of blood cells can lead to complications during childbirth, as the likelihood of intrauterine fetal hypoxia increases.

If the level of red blood cells in the blood is low during pregnancy, a woman may feel a deterioration in her overall health. The following symptoms become serious reasons for examination:

Frequent weakness, sometimes bordering on fainting.
Lethargy and constant drowsiness, appearing even immediately after waking up.
Chronic fatigue.
Low blood pressure.
Dryness and pale appearance of the skin.

If such symptoms occur, a woman is advised to consult a doctor who is registered with her. Most likely, some research will be needed to rule out a threat to the child’s development.

Taking blood from a pregnant woman

A pathology manifested by a decrease in red blood cells in the body of a pregnant woman is called erythropenia. There are many factors that can provoke the disease:

disturbances in the functioning of the body's hormonal systems;
taking certain medications;
anemia of any kind;
autoimmune diseases;
loss of blood in large quantities;
poor quality and unbalanced nutrition;
disorders of the liver and heart, kidney dysfunction;
deficiency of iron in the body and B vitamins;
the occurrence of chronic inflammatory processes in the body;
oncological diseases actively accompanied by the growth of metastases;
the period between pregnancies is too short;
exhaustion of the nervous system due to stress.

Attention! A low blood cell count is considered normal only in the early stages of pregnancy. If over time the cell level does not normalize and even continues to decrease, then you should not delay visiting a doctor.

Principles of treatment

Naturally, first of all, the doctor will try to identify the cause of this pathological condition of the woman. The next step to normalize the situation will be to eliminate the factors that caused the decrease in NST in the body.

There are several ways to increase hematocrit in the blood:

Taking medications whose action is aimed at increasing iron levels in the body,
Long walks in the fresh air to replenish oxygen deficiency in cells and enrich yourself with vitamin D,
Try to avoid stressful situations
Review your diet.

Since iron deficiency anemia is the most common cause of low NBT levels, the first thing the doctor will do is prescribe iron-containing medications. Please note: self-medication is excluded in this case, since all the nuances are important for the proper development of the baby: choice of drug, its dosage, side effects.

These medications include:

Nutritional supplements,
Vitamin complexes,
Ferrous sulfate and gluconate, other compounds.

In case of severe iron deficiency, taking oral medications may be ineffective, and then the medicine is administered intravenously (Venofer). As a result of side effects, a pregnant woman may have: heartburn and dyspeptic disorders.

You also need to review your daily menu. It is imperative to eat foods rich in iron and vitamin C (for its absorption).

That is, the diet should contain:

Eggs, Nuts, Fruits

Particular attention should be paid to sour apples, meat, liver, liver and offal... Dark chocolate and hematogen are allowed in small quantities. Naturally, the expectant mother needs to switch to a healthy diet, excluding soda, fast food, alcohol, spicy and salty foods.

Naturally, the expectant mother needs to switch to a healthy diet, excluding soda, fast food, alcohol, spicy and salty foods.

Bitter chocolate and hematogen are allowed in small quantities. Naturally, the expectant mother needs to switch to a healthy diet, excluding soda, fast food, alcohol, spicy and salty foods.

Read further:

A child’s hematocrit is increased or decreased - what does a deviation from the norm mean?

Pulse during pregnancy - norms for women in different trimesters, reasons for high and low values

Blood color index is low in a child - causes, normal, treatment

Homocysteine when planning pregnancy and during it - the norm and reasons for increase or decrease

Temperature during pregnancy is 37 degrees and above - reasons for how to bring it down in different trimesters

Norm of ESR in children by age with a table, reasons for increased and decreased levels in the blood

If your white blood cells are elevated

First of all, it should be noted that laboratory standards for leukocytes are not strict, that is, indicators that differ by a few tenths from the norm indicated in the table (or on the form) are not a cause for alarm. Leukocytes may increase slightly during pregnancy, during the premenstrual period, as well as after meals and simply in the evening. This is why people are usually asked to donate blood on an empty stomach.

A significant increase in white blood cells is always a serious symptom that requires clarification of the cause. There can be many reasons, but the main three are:

infectious diseases (acute and chronic), and this is not only ARVI and pneumonia. For example, with abdominal pain, elevated white blood cells help to distinguish appendicitis from intestinal colic;
oncological diseases, including tumors of the blood system (leukemia);
inflammatory diseases, for example, some rheumatic diseases.

A certain clue is given by a change in the “leukocyte formula” - this is what doctors call the ratio of neutrophils, lymphocytes, monocytes and eosinophils. An increase in neutrophils often indicates a bacterial infection, lymphocytosis often accompanies a viral infection, and eosinophilia is a sign of allergic diseases or helminthic infestation.

Decreased white blood cells

A few words about low leukocyte levels. This is a situation that always requires certain diagnostic maneuvers, since suppression of hematopoiesis is a rather serious symptom. Therefore, the advice here is very simple: if your white blood cells are below normal, go to the doctor. The diagnostic path may not be very simple, but it must be followed.

By the way, one of the reasons for the decrease in leukocytes may be, oddly enough, headache pills. Yes, yes, banal analgesics, when taken frequently and regularly, can inhibit bone marrow function. Don't forget about this, those who swallow painkillers by the handful.

A young woman arrives. There is nothing to worry about, only the leukocytes in the blood test are low. In several repeated analyzes the indicator

— Painkillers? Well, yes, I take it sometimes: analgin and other various analgesics that are sold in pharmacies. Often, yes, almost every day.

A full hematological examination was carried out, including a bone marrow puncture, and, fortunately, nothing wrong was found. I was forbidden to take painkillers, and after a couple of months my blood counts recovered.

Over-the-counter analgesics are not a toy. Drugs based on metamizole (analgin, baralgin, etc.), although rare, can cause very severe bone marrow damage.

But chronic headaches must be treated completely differently.

Red blood cells in the blood during pregnancy, what is this indicator?

Red blood cells are produced in the red bone marrow. They are utilized in the spleen. During development, they form hemoglobin, which contains protein and iron. This structure is necessary for the cell to absorb oxygen and carbon dioxide. The first substance is transferred from the alveoli of the lungs to the organs. From there, red blood cells collect carbon dioxide, which is transported back to the pulmonary system.

For healthy people without gestation, the indicator should be in the range of 3.5-5.5 × 1012 cells/l.

There are two types of indicator changes:

erythropenia – decreased number of red cells;
erythrocytosis - increased value.

There are physiological and pathological causes of the disorder. In the first case, treatment is not required; the factors that caused the changes should be eliminated. In the second case, the indicator will return to normal when therapeutic measures are carried out.

Red blood cells are determined using a general clinical blood test. It can be done in two ways.

Microscoping. The doctor places a stained sample of human biological fluid under a microscope, and the cells in the field of view are determined. To do this, the microscope is moved from left to right, down, right to left. That is, they count the cells manually. The disadvantage of the method is the lack of calculation of the value in the entire volume of biological fluid. It is determined only in 1 ml. The positive side is the determination of the shape, structure, and quality of cells. Other disorders may be detected, the appearance of substances that should not normally be present.
Application of a semi-automatic hematology analyzer. After collecting the biomaterial, the doctor adds an anticoagulant, which prevents the biological fluid from coagulating and forming a clot. The device takes liquid from the test tube. The analyzer automatically calculates the parameters and issues a research form. The analysis eliminates the medical error factor, but does not determine every other parameter.

Learn more about red blood cell counting methods and possible errors.

To minimize the risk of errors in the process of microscopy and the use of semi-automatic analyzers, two methods are carried out at once. This is how the most reliable results are revealed.

After receiving the results form, the patient must take them to the attending physician. It is impossible to independently determine the reason for a change in any indicator. The doctor may order other diagnostic tests if abnormal.

Important! To determine the most reliable values, two tests are prescribed. If the data is identical, the information is true

Indications for testing for red blood cells during pregnancy

During gestation, a woman undergoes laboratory tests every 2 weeks. This allows the doctor to identify health abnormalities at an early stage. The sooner treatment begins, the lower the risk of complications for the woman and the fetus.

There are the following indications for taking the test:

prevention for timely detection of deviations from the norm;
detection of anemia in previous tests;
detection of erythrocytosis in previous tests (increased number of red cells);
low or high levels of iron in the blood;
low or high hemoglobin levels;
diabetes;
the presence of an increased number of red blood cells in the urine;
the presence of a malignant blood disease;
identified area of minor or significant bleeding;
determining the quality of treatment;
chronic diseases that can lead to bleeding.

If the results indicate a decrease or increase in the indicator, the doctor will prescribe additional diagnostic tests that will help identify the cause.

How to deal with iron deficiency anemia?

Since this is the cause of deviations in blood counts in 95% of women, the main attention should be paid to eliminating iron deficiency. How to deal with anemia?

Adjusting your diet

. Pregnant women need to eat foods rich in iron every day. These include liver, eggs, nuts, fruits, beets, and pomegranate. In addition, you can buy pharmacy Hematogen bars.

Taking iron supplements

. Patients are prescribed medications that quickly restore the body's need for iron-containing products. These could be vitamin complexes, nutritional supplements, or ferrous sulfate. For acute blood loss, medications are administered intravenously.

Walks in the open air

. Despite the banality of the recommendation, it can strengthen the body and increase hematocrit, since during physical activity all indicators return to normal.

Elimination of stressful situations

During the period of bearing a child, it is very important to remain calm. Any stress and emotional stress negatively affects health and impairs blood circulation

Therefore, it is better to postpone all matters that require nervous tension until after the birth of the baby.

Separately, we can dwell on the use of iron supplements in the treatment of IDA. They are required in cases where the patient has poor absorption of the element from food. Most often this happens with diseases of the gastrointestinal tract, inflammation of the gastric mucosa. Then doctors individually select the dosage of ferrous sulfate. Typically the dose is no more than 180 mg per day. It is combined with drinking citrus juices at night. But the exact prescription must be determined by the doctor.

If the tablets cause symptoms of side effects, such as heartburn, vomiting, flatulence, then intravenous administration and administration of iron dextran every other day for 3 weeks is possible.

In any case, low Hct should not be ignored. In the early stages of the development of the disease, it is much easier to eliminate the problem than to treat an advanced condition.

The normal intrauterine development of the child depends on the number of red blood cells in a woman’s circulatory system. To assess the ability of blood to carry oxygen, the hematocrit value is determined. When the hematocrit is low during pregnancy, doctors suspect the formation of hypoxia, which threatens the development of the baby.

What to do if red blood cells and hematocrit are low during pregnancy

If it so happens that the gynecologist discovered a low hematocrit in your tests, then first of all he will try to identify the reason for this in order to prescribe the correct course of treatment and eliminate all factors that could contribute to a decrease in the hematocrit number in the blood of a woman in an interesting situation.

Typically, doctors choose one or more of the following treatment regimens:

Prescribed medications that help normalize iron levels in the blood.
They suggest taking additional vitamin D and walking in the fresh air as often as possible.
Bed rest and rest are prescribed.
A diet is prescribed that will enrich a woman’s blood with iron.

Medicines that can be taken during pregnancy with a low hematocrit

Taking iron-containing medications is the surest way to correct the situation with a low hematocrit level in the blood of a pregnant woman. But this does not mean that the expectant mother should go to the pharmacy and buy the drug that the pharmacist recommends to her. Self-medication has never brought anyone any benefit. Go to your doctor so that he can recommend you which drug is best to buy in your case.

The most commonly prescribed drugs include:

B12 is a vitamin that can be found in pharmacies under the name “Cobamamide”. It is sold in ampoules and costs about 1,400 rubles. You need to take this medicine once a day, 2 ampoules per dose. It should not be used by pregnant women who have an individual intolerance to any of the components of this drug.
Sodium chloride is a solution available to everyone, which costs about 50 rubles. It is used according to simple instructions if a woman has internal swelling.
Ferrous sulfate is a drug that is sold in pharmacies in tablet form. It costs differently. If you choose a domestically produced medicine, you will spend only 50 rubles, and if imported, then all 500. Please note that if you have a stomach ulcer, this medicine is prohibited from being used during pregnancy.

Diet to normalize the level of hematocrit in the blood of a pregnant woman

If, due to medications, a pregnant woman feels heartburn or has vomiting or flatulence, then it is better to stop taking them and give preference to proper nutrition. Adjust your diet to include plenty of foods that contain iron. These include:

meat products (mainly beef);
liver with hearts and other offal;
eggs (preferably boiled);
green sour apples (they have a very high concentration of iron);
any nuts (but you can’t eat them if you have high blood pressure, as they will make it even higher);
black chocolate.

If you are in an excellent position and are expecting a baby, then be sure to monitor the hematocrit number in the blood, because it will determine whether your pregnancy will proceed normally or not. If you feel weak, take action immediately, because there is a high risk that not only you, but also a defenseless baby who needs your help will suffer from iron deficiency in the blood. Follow your doctor's recommendations and take care of your health!

How to increase the number of red cells to normal in case of detected diseases?

If the patient has been diagnosed with any pathological changes that affect the thickness of the blood, then the provocateur is treated.
The hematocrit will return to normal after the underlying disease is eliminated. Helminthiasis;

Anthelmintics of herbal or pharmaceutical origin are prescribed. They also give recommendations on food hygiene to prevent helminth infection.

Gynecological diseases;

Conservative medications that are safe for the fetus are prescribed. But when myomatous nodes develop, causing severe blood loss, they take risks and undergo surgery.

Congenital pathologies;

If a woman has a violation of hemoglobin synthesis or is diagnosed with sickle cell anemia, then therapy is carried out symptomatically. The main treatment is to prevent complications. Taking hormonal drugs gives a temporary effect. But the problem can be radically solved only by bone marrow transplantation.

Chronic oxygen deficiency;

Almost always occurs in patients who smoke. In this case, the woman herself must decide to give up the bad habit, otherwise no therapy methods will give a positive result. Medicines will not be able to help increase Hct, since their effectiveness is lost due to intoxication of the body.

Without treatment of the underlying disease, women may experience premature labor or repeated miscarriages.