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Q: My wife is 26 weeks pregnant. In the last forty days she has put on more than 5 kg. Is there reason to worry? Also the doctor after a scan said that the EDD is earlier than it should be. The reason she has given for the advanced expected date is that I am tall. Does this make sense? Her haemoglobin is 9.7 .What if the Hb count does not improve?
A: In a normal pregnancy a woman gains about 11 kg (usually 1 kg in the first trimester and 5 kg each in the next 2 trimesters). A weight gain of 5 kg in 40 days is not usually normal and could be the predecessor of an underlying pregnancy complication like pregnancy induced hypertension, where excess weight gain is due to excessive water retention. Your height or the sex of the baby has nothing to do in the determination of the EDD--expected date of delivery. I suggest you give her iron supplementation and a high protein diet to improve her haemoglobin. The haemoglobin values are never an indication for caesarean section. At times your wife may have spotting on the day of the expected period but she may have already conceived in the earlier period. Thus this miscalculation could result in a difference of nearly 4 weeks.
Q: My wife is 25 weeks pregnant. She has normal Hb A2 thalasemia. Her present Hb is 7.3, serum iron is 64 and TIBC is 421. Her Hb remains in the range of 7-8 normally. Her Hb has not dropped on account of pregnancy. Her foetal growth is normal till now and she has no complaints so far. Please advise us if she would require any blood transfusion in the coming weeks. She is presently taking Raricap, Folvite, Shelcal (calcium) and vitcofol injections. Kindly give your opinion on her case.
A: It appears from the information that you have sent me that your wife has thalasemia minor, a condition in which pregnancy, if monitored properly, can be taken up to term without having any adverse effects on either the baby or the mother. However, if one of the partners has thalasemia minor, it becomes essential to check the haemoglobin pattern by electrophoretic studies of the other partner ? because if both partners have thalesemia minor there is a 50% chance of the baby ending up with thalasemia major ? a life threatening condition. If you too have a thalasemia trait I would advise you to go in for cordocentesis to check the babies haemoglobin type. Otherwise the pregnancy seems to be doing ok. A high protein diet and iron supplements are required throughout. We do not like to give blood in pregnancy unless hb is<6gm%.
Q: I am a week into my 2nd trimester. I had a blood test done earlier when my Hb count was found to be 9.8. We checked with our doctor for any additional iron dosage but were advised that this was not required now and could be started after the end of the 1st trimester. I had a blood test done again and now the Hb count is very low - 7.7. The doctor has started me on a dose of Fe tablets 600mg and also a course of 10 injections. I have been having an iron rich diet during the last month but my Hb count is still low. What can I do to bring my Hb content up again? Any specific diet advice (we are vegetarians)? Do I really need these injections? They are very painful.
A: With double doze of iron and injections the Hb should improve. But if it does not, this may be due to some worm infestation in the intestines or due to any other blood problem. It usually takes a month for the Hb to rise hence you should repeat the test after 4 weeks to see if there is any increase. In the meantime lay stress on your diet which should include a lot of green vegetables ? beans, coriander leaves and spinach. Try and have spinach soup everyday. You have adequate time to build up your Hb, so do not worry.
Q: My wife is 3 months pregnant. She has a low haemoglobin. Will this in any way complicate the pregnancy? What steps can we take to avoid any complications? Our niece is affected by rubella virus. Will this in any way have an affect on my wife?
A: Low haemoglobin levels lead to a condition known as anaemia which must be investigated and promptly corrected at all times, especially so in pregnancy. Only severe anaemia could cause complications during pregnancy, so it is best that she starts having iron-rich foods like green vegetables, spinach. At some point, usually in the fourth month or so, your doctor will start you on a daily iron supplement. Your wife?s nephew having rubella is not likely to affect this pregnancy in any way.
Q: What is haemoglobin? If the haemoglobin count is less at the time of pregnancy, how can it be increased?
A: Haemoglobin is a protein that carries oxygen to the various parts of the body. If the count is low, it means less intake of oxygen, which results in weakness and low birth weight of the baby. The mother should take iron supplements, spinach, methi, apples, cabbage and bananas, all of which are rich in iron.
Q: I am 6 months pregnant. My haemoglobin count is 9.2, which is low. 1. What could be the reason for this? 2. Are there any risks to my baby? 3. What precautions should I take and what should I do to bring my blood count to normal?
A: 1. The reasons for low Hb may be worm infestation which can be detected by having a stool test done. It could also be caused by a faulty diet. You must take plenty of green vegetables during pregnancy. 2. It may cause poor growth of the baby inside the uterus or it may also lead to premature onset of labour. But this can be avoided by taking proper rest and returning the Hb to normal. 3. Firstly make sure that anaemia is due to deficiency of iron and vitamins and not to any other condition eg. Thalesemia. Once this is ruled out, make sure your diet includes plenty of fruits and green vegetables. Also, take iron and vitamins regularly.
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