The prominent hematologic changes in pregnancy are physiologic anemia, expanded plasma volume, mild thrombocytopenia, a mild prothrombotic state, and in some individuals, mild neutrophilia. The physiologic anemia results from an increase in plasma volume of 50% compared to increase in red cell mass of 20% resulting in a physiologic drop in hemoglobin. concentration.

• Nutritional e.g. Iron deficiency anemia.
• Infections e.g. malaria, hook worm infestation.
• Hemoglobinopathies e.g. sickle cell disease anemia.
• Acute blood loss e.g. placenta praevia.
• Chronic medical conditions e.g. chronic kidney disease.

Dizziness, nausea, headache, weakness, lethargy, tiredness, palpitation, dyspnea, pallor, tachycardia and tachypnea.

Full blood count, electrolyte urea and creatinine, blood group and genotype, peripheral blood film, stool for ova and parasite and serum ferritin.

There are many effective ways to treat and prevent anemia in pregnancy. The treatment of anemia depends on the underlying cause of the condition. Changes in diet can help reduce anemia in pregnancy in cases associated with poor diet. Foods rich in iron, folate, vitamin C and vitamin B12 are particularly beneficial. 

Iron deficiency anemia is the most common pathologic cause of anemia in pregnancy and treatment is based on the severity of the anemia.

• For mild anaemia (10-10.9g/dl), treatment is mainly with the use of oral iron preparations which include ferrous sulphate, ferrous gluconate and ferrous fumarate. 
• For moderate anemia (7-9.9g/dl), this can be treated with parenteral iron preparations like ferric carboxymaltose, iron sucrose and iron dextran.
• For severe anemia (less than 7g/dl), this can be treated with parenteral iron preparations or blood transfusion

For other health conditions that cause Anemia in Pregnancy, steps that can be taken include:

• Prevention and treatment of malaria. The prevention of malaria is achieved with use of intermittent preventive treatment (IPT) for malaria amongst other strategies which include use of insecticide treated nets and indoor residual spraying. The use of artemisinin combination therapy is recommended for the treatment of malaria in pregnancy.
• Prevent and treatment of hookworm infestation and other infections caused by soil-transmitted helminths (parasitic worms) with the use of anti-helminthic agents.
• At least 24 months interval between pregnancies for adequate child spacing and the use of contraceptives to prevent unintended pregnancies.
• Prevention and treatment of anemia from heavy menstrual bleeding before pregnancy
• Preconceptional care and tertiary level care for women with hemoglobinopathies and other chronic medical disorders before and during pregnancy.
• Avoidance of teenage pregnancy which is a risk factor for anemia in pregnancy.

Maternal complications with anemia in pregnancy include preterm rupture of membrane, preterm contraction, preterm delivery, infection, postpartum depression, postpartum hemorrhage and maternal death. 

Fetal complications with anemia in pregnancy include miscarriage, intrauterine growth restriction, prematurity, stillbirths, low birth weight, perinatal mortality and neonatal sepsis.

Anemia is a significant public health problem and quality antenatal care plays an important role in the prevention and treatment of anemia in pregnancy.