scholarly journals Prevalence of hemolytic anemia and hemoglobinopathies among the pregnant women attending a tertiary hospital in central India

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Ranbir S. Balgir

<p>Anemia in pregnancy is one of the causes of maternal morbidity and, maternal and fetal mortality in India. Hemoglobin transports oxygen to different parts of the body. Any defect in hemoglobin structure leads to its adverse functions. Screening of pregnant women for hemoglobinopahties helps in early intervention for reducing morbidity and mortality. Although the prevalence of hemoglobinopathies especially of the sickle cell disorders is high in Madhya Pradesh but any study on pregnant women is lacking. This study had set the objectives to find the prevalence of anemia and hemoglobin disorders in pregnant women, and to determine the health status through hematological indices profile in central India. Hospital based a cross-sectional study showed 12.26% prevalence of hemoglobinopathies among 416 pregnant women, the sickle cell trait being 7.45%, followed by β-thalassemia trait (2.89%), hemoglobin E trait (0.24%), and sickle cell disease (1.68%). About 88% of the pregnant women were found free of hemoglobinopathies. Of the 9.13% pregnant women included in the study were suffering from sickle cell disorders. However, the overall 47.11% anemia was observed in pregnant women, ranging in between 45% to 66% and seemed to show a reduction in anemia after nutritional supplementations and improvement in maternal health care at antenatal check up due to accessibility to medical health facilities. A comparison of hematological indices of pregnant women afflicted with and without sickle cell disorders have revealed much reduced hemoglobin level, red blood cells count, mean corpuscular volume, hematocrit, and mean corpuscular hemoglobin; and raised leucocytosis in sickle cell disorder cases than among the normal pregnant women. A more vigorous and realistic campaign of prophylactic regime of supplementations for these pregnant women and child health care is suggested.</p><p> </p><p>妊娠期贫血是印度产妇母体发病率以及母婴死亡率的原因之一。 血红蛋白将氧输送到身体的不同部位。 血红蛋白结构的任何缺陷都导致其功能不良。 孕妇的血红蛋白病筛查有助于早期干预,降低发病率和死亡率。 虽然血红蛋白病特别是镰状细胞病的患病率在中央邦较高,但对孕妇的任何研究都很缺乏。 本研究将目标设为找出孕妇贫血和血红蛋白病患病率,并通过印度中部的血液指标情况来确定健康状况。 医院基于一项横断面研究显示了416名孕妇中12.26%的血红蛋白病患病率,镰状细胞特征为7.45%,接下来是β地中海贫血特征(2.89%)、血红蛋白E特征(0.24%)和镰状细胞病(1.68%)。 约88%的孕妇被发现未患血红蛋白病。 纳入研究的孕妇有9.13%患有镰状细胞病。 然而,在孕妇中观察到总体47.11%的贫血,范围从45%到66%之间,在营养补充以及由于医疗卫生设施可及性原因在产前检查时孕妇健康护理改善后,看来显示出贫血的减少。 对患有或未患镰状细胞病的孕妇血液学指数的比较揭示出,镰状细胞症病的病例与正常孕妇相比血红蛋白水平、红细胞计数、平均红细胞容积、血细胞比容和平均红细胞血红蛋白有很大降低,以及有白细胞的增多。 建议对于这些孕妇和儿童的卫生护理的预防性补充方案采取更积极并且更切实际的活动。</p>

2014 ◽  
Vol 6 (1) ◽  
pp. e2014060 ◽  
Author(s):  
R S Balgir

Background: Red cell inherited hemoglobin anomalies are commonly encountered in the central region of India. These cause a public health concern due to high degree of morbidity, mortality, and fetal loss in the backward, underprivileged, and vulnerable people. Purpose: To report five typical families of hemoglobin E disorders identified for the first time in the state of Madhya Pradesh from central India. Methods: Out of a total of 445 couples/families (excluding the present study) with 1526 persons (848 males and 678 females) referred from a tertiary hospital in central India for investigations of anemia/hemoglobinopathies during the period from March 2010 to February 2014, we came across five typical rare couples/families of hemoglobin E disorders worthy of detailed investigations. Laboratory investigations were carried out following the standard procedures after cross checking for quality control from time to time. Results: For the first time, we have encountered nine cases of heterozygous hemoglobin E trait, two members with hemoglobin E-β-thalassemia (double heterozygosity), two cases of sickle cell-hemoglobin E disease (double heterozygosity), and none with homozygous hemoglobin E. Cases  of hemoglobin E trait, hemoglobin E-β-thalassemia, sickle cell-β-thalassemia and sickle cell-E disease showed moderate to severe anemia, and target cells, and reduced values of red cell indices like RBC, Hb level, HCT, MCV, MCH and MCHC, representing abnormal hematological profile and clinical manifestations before blood transfusion. Conclusions: Double heterozygosity for hemoglobinopathies such as occurrence of β-thalassemia mutation with structurally abnormal hemoglobins (Hb S and Hb E) is a rare entity, but occurs with severe clinical manifestations only in those areas or communities where these are highly prevalent, testifying the migrations and genetic admixture. Distribution of hemoglobin E and β-thalassemia in different districts of Madhya Pradesh indicates that abnormal Hb E gene has wide spread and needs prevention for the rehabilitation of vulnerable people in central India. 


2011 ◽  
Vol 20 (5) ◽  
pp. 498-504 ◽  
Author(s):  
Yvonne Bombard ◽  
Fiona A Miller ◽  
Robin Z Hayeems ◽  
Brenda J Wilson ◽  
June C Carroll ◽  
...  

Author(s):  
Shubhranshu Shekhar

Several biological factors, particularly haematological, are physiologically altered during normal pregnancy. Biologists and doctors who are aware of these changes in the maternal body can screen for potential abnormalities. The aim of this research is to find healthy pregnant women's reference values. This was a cross-sectional research of pregnant women who attended an antenatal clinic at Sree Balaji Medical College, with anaemic and non-anemic pregnant women. Pregnant women were categorized into three groups -Group I - First Trimester (50 cases); Group II - Second Trimester (50 cases) and Group III - Third Trimester (72 cases) while non­ pregnant women formed the fourth group (30 cases). A statistically significant difference between the pregnant women and control group was noted (p < 0.05) for all the hematological parameters: red blood cells, hematocrit, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, leukocytes, neutrophils, basophils, eosinophils, lymphocytes, monocytes, platelets and mean platelet volume. The present study provides additional baseline data for basic hematological parameters in healthy pregnant women and concluded that pregnancy in women has the tendency to alter some hematological indices.


Author(s):  
Kennedy Diema Konlan ◽  
Joseph M. Kombat ◽  
Milipaak Japiong ◽  
Kennedy Dodam Konlan

Background: Maternity period is crucial and sensitive in the life of women due to various physiological changes that take place in the body during pregnancy and after. These changes need close monitoring to help optimize maternal and foetal health. This study explored pregnant women’s perceptions of maternity care services in the Volta Regional Hospital.Methods: Multiparous women (170) in the Ante Natal Clinic responded to a pretested questionnaire. The sample size was determined using Fischer’s formula for sample size calculation. Respondents were chosen using the convenient sampling method. The data was analysed using Statistical Package for Social Sciences version 20 in to descriptive statistics.Results: This study identified that women (42.5%) were never encouraged by health care providers to bring their partners during antenatal visits. Pregnant women (62.9%) reported that health care professionals did not allow their support persons including their husbands to be with them during labour. Women (34.1%) during labour were sometimes assaulted while 2.9% were always assaulted. Majority (74.2%) of the women received this five cardinal services that included vitamin K, eye care, cord care, bathing and immunization during the post natal period as 60.7% were introduced to family planning by midwives.Conclusions: Partner involvement in maternal health care needs to be encouraged by midwives to improve support from partners during pregnancy, labour and the post natal period. Support persons should be allowed to stay with women during labour to give the necessary support and encouragement and also take part in decision making concerning women’s care.


2021 ◽  
Vol 2 (2) ◽  
pp. 25-37
Author(s):  
Isadora Garcia Pires ◽  
Iluskhanney Gomes de Medeiros Nóbrega Miranda ◽  
Ingrid Rafaella Mauricio Silva Reis ◽  
Juscelino Kubitschek Bevenuto Da Silva

A anemia falciforme (AF) é uma doença autossômica recessiva, que leva à produção de hemoglobina anormal, denominada hemoglobina S (HbS). Seus portadores sofrem com o crescimento deficiente, desde a infância, além de disfunções endócrinas, baixo consumo alimentar, alto requerimento energético, deficiência de minerais, que podem resultar em desnutrição. Durante a gestação, está associada ao aumento de complicações relacionadas à própria doença, morbimortalidade materna e perinatal mais elevada, nascimento de crianças com baixo peso e maiores taxas de complicações infecciosas puerperais. O objetivo do estudo foi buscar, através de uma revisão integrativa, esclarecer sobre o estado nutricional e as complicações clínicas de gestantes com anemia falciforme. Para tanto, realizou-se um estudo exploratório, por meio de pesquisa bibliográfica. Sendo a seleção e a localização das referências retiradas das bases de dados PubMed/LILACS, Plos One e da biblioteca eletrônica SciELO, utilizando também a Biblioteca Virtual em Saúde (BVS), a fim de identificar artigos científicos publicados no período entre 2008 e 2020, utilizando os seguintes descritores: anemia falciforme e intercorrências obstétricas; anemia falciforme e gestante; hemoglobina S e gestante e versões em inglês. Verificou-se que gestantes portadoras de anemia falciforme possuem maior propensão a complicações, como aborto espontâneo, crescimento intra-uterino restrito, aumento da mortalidade fetal intra-útero, recém-nascido de baixo peso, trabalho de parto pré-termo, somados à deficiência de macro e micronutrientes durante o período gestacional, podendo chegar à desnutrição materna e à morbimortalidade materna e neonatal. Em suma, a suscetibilidade à desnutrição materna, infecções, complicações hemolíticas e vaso-oclusivas de gestantes com anemia falciforme mostrou-se um prognóstico desfavorável, trazendo consigo complicações para a mãe e o neonato. Reforçando a importância do acompanhamento nutricional como estratégia de prevenção e orientação relativas às alterações nutricionais das gestantes portadoras da doença, como alternativa para a minimização dos resultados adversos e garantir melhoria da saúde materna e fetal.   Sickle cell anemia (SCA) is an autosomal recessive disease that leads to the production of abnormal hemoglobin called hemoglobin S (HbS). Their carriers suffer from deficient growth, since childhood, in addition to endocrine dysfunction, low food consumption, high energy requirement, mineral deficiency, which can result in malnutrition. During pregnancy, it is associated with an increase in complications related to the disease itself, higher maternal and perinatal morbidity and mortality, birth of low birth weight children and higher rates of puerperal infectious complications. The aim of the study was to seek, through an integrative review, to clarify the nutritional status and clinical complications of pregnant women with sickle cell anemia. For that, an exploratory study was carried out, through bibliographical research. With the selection and location of references taken from the PubMed/LILACS, Plos One and SciELO electronic library databases, also using the Virtual Health Library (VHL), in order to identify scientific articles published in the period between 2008 and 2020, using the following descriptors: sickle cell anemia and obstetric complications; sickle cell anemia and pregnant women; hemoglobin S and pregnant women and English versions. It was found that pregnant women with sickle cell anemia are more prone to complications, such as miscarriage, restricted intrauterine growth, increased intrauterine fetal mortality, low birth weight newborn, preterm labor, in addition to disability of macro and micronutrients during the gestational period, which can lead to maternal malnutrition and maternal and neonatal morbidity and mortality. In short, the susceptibility to maternal malnutrition, infections, hemolytic and vaso-occlusive complications of pregnant women with sickle cell anemia proved to be an unfavorable prognosis, bringing with it complications for the mother and the newborn. Reinforcing the importance of nutritional monitoring as a prevention and guidance strategy regarding nutritional changes in pregnant women with the disease, as an alternative to minimizing adverse outcomes and ensuring improved maternal and fetal health.


2020 ◽  
Vol 10 (1) ◽  
pp. 1645-1649
Author(s):  
Nisha Sharma ◽  
Anil Dev Pant ◽  
Usha Manandhar

Background: Thalassemia and other structural hemoglobinopathies are the most common single gene disorders throughout the world with the highest frequency in the tropics, subtropics, Mediterranean basin and Southeast Asia. This study aims to provide a better assessment on the spectrum of hemoglobinopathies in our context. Materials and Methods: This descriptive study was done at our tertiary care center, from November 2014 to October 2015. Hematological indices were derived from coulter counter, haemoglobin electrophoresis was carried out by cellulose acetate medium at alkaline PH. Sickling test, Hb H inclusions demonstration and Hb F estimation were performed. Parental screening was done wherever feasible. Results: Out of 350 cases referred from various out-patient departments of TUTH and different peripheral hospitals for suspected hemoglobinopathies, 97 cases (27.71%) had hemoglobinopathies. The most predominant hemoglobinopathy was thalassemia (57.73%) followed by sickle cell disorders (28.87%) and Hb D/Hb E hemoglobinopathies (13.40%). Most disorders were observed in the age group 21-30 years with many of the cases seen clustered in the families and a slight male preponderance. Terai region (71.13%) had a very high number. A significant high frequency of thalassemia (33.93%) and sickle cell disorders (75%) were seen in Tharu community. Conclusion: Hemoglobinopathies were seen widespread in Nepal. An extensive screening of the population is important to assess the prevalence of hemoglobinopathies, which will help in identification of carriers and take adequate therapeutic and preventive measures.  


Author(s):  
Pramukti Dian Setianingrum ◽  
Farah Irmania Tsani

Backgroud: The World Health Organization (WHO) explained that the number of Hyperemesis Gravidarum cases reached 12.5% of the total number of pregnancies in the world and the results of the Demographic Survey conducted in 2007, stated that 26% of women with live births experienced complications. The results of the observations conducted at the Midwife Supriyati Clinic found that pregnant women with hyperemesis gravidarum, with a comparison of 10 pregnant women who examined their contents there were about 4 pregnant women who complained of excessive nausea and vomiting. Objective: to determine the hyperemesis Gravidarum of pregnant mother in clinic. Methods: This study used Qualitative research methods by using a case study approach (Case Study.) Result: The description of excessive nausea of vomiting in women with Hipermemsis Gravidarum is continuous nausea and vomiting more than 10 times in one day, no appetite or vomiting when fed, the body feels weak, blood pressure decreases until the body weight decreases and interferes with daily activities days The factors that influence the occurrence of Hyperemesis Gravidarum are Hormonal, Diet, Unwanted Pregnancy, and psychology, primigravida does not affect the occurrence of Hyperemesis Gravidarum. Conclusion: Mothers who experience Hyperemesis Gravidarum feel nausea vomiting continuously more than 10 times in one day, no appetite or vomiting when fed, the body feels weak, blood pressure decreases until the weight decreases and interferes with daily activities, it is because there are several factors, namely, hormonal actors, diet, unwanted pregnancy, and psychology.


Sign in / Sign up

Export Citation Format

Share Document