Normal hemoglobin levels in pregnant women

The normal hemoglobin value of pregnant women is different from that of ordinary people. If you find that your hemoglobin is abnormal during the test, don’t worry too much. This problem will occur during pregnancy. The most important thing is to pay more attention to conditioning in your life, try not to let your body show any fatigue, and combine work and rest.

1. Medical history and symptoms

⑴ Questions about medical history: Note: ① Whether there are similar patients among parents and family members. ②Age of onset. ③Growth and development status.

⑵Clinical symptoms: general symptoms of anemia, poor appetite, developmental delay, diarrhea and susceptibility to infection.

2. Physical examination findings

In addition to the anemic appearance, there may be mild jaundice, raised cheekbones, sunken nose bridge, widened eyes, irregular heartbeat, enlarged heart dullness, and enlarged liver and spleen.

3. Auxiliary examination

(1) Blood picture: Hemoglobin is more than 60g/L, presenting microcytic hypochromic anemia, red blood cells vary in size and shape, target cells account for more than 10%, and red blood cell fragments can be seen. Reticulocytosis. There are inclusion bodies in red blood cells. White blood cells and platelets are normal or decreased.

(2) Bone marrow: active proliferation, obvious proliferation of erythroid cells. Extracellular iron and sideroblasts increased.

(3) Hemoglobin electrophoresis: Hemoglobin F is greater than thirty molecules per hundred (severe β-globin production disorder). Hemoglobin Bart is greater than 80 molecules per hundred (hemoglobin Bart fetal edema syndrome); hemoglobin H band appears in electrophoresis (hemoglobin H disease).

(4) It is possible to conduct α- and β-globin peptide chain synthesis ratio and gene analysis.

4. Differential diagnosis

It should be differentiated from iron deficiency anemia and other hemoglobinopathies.

There is currently no radical cure for abnormal hemoglobin diseases. Some patients have a good prognosis without treatment and it does not affect their survival. Some patients need supportive conservative treatment, such as preventing and actively treating infections, supplementing hematopoietic factors, avoiding low oxygen and hypoxic environments, avoiding taking oxidant drugs, and blood transfusion when necessary.

1. Blood transfusion

When the hemoglobin level is lower than 80 g/l, blood transfusions should be given regularly to keep the hemoglobin level above 80 g/l. When high blood transfusion volume therapy is used, hemoglobin should be maintained above 100 g/l.

2. Splenectomy

Splenectomy should be performed for patients with hypersplenism, compression symptoms caused by enlarged spleen, and increased blood transfusion requirements. Splenectomy after 4 years of age can significantly reduce infectious complications.

3. Chelation therapy

Deferoxamine: 1.5-2.0 g/d, subcutaneous injection, or 3-4 g/d, intravenous drip, continued for 18-20 hours. Vitamin C 150~300 mg/d, orally.

4. Bone marrow transplant

Those who are able should undergo bone marrow transplantation.