Red blood cells in the blood are low during pregnancy: possible causes and therapy

Purpose of erythroid cells in the body of pregnant women

A reduced level of red blood cells in the blood during pregnancy is normal if it is within certain limits:

It is believed that more than 40 percent of women are susceptible to this condition due to the fact that the level of fluid in their body increases and the blood becomes diluted.
If there is a sharp decrease in the number of erythroid cells, they begin to talk about the development of anemia, although this is not considered the main sign of the onset of anemia.

A decrease in the number of red blood cells in early pregnancy can create unfavorable conditions for the development of the internal organs of the unborn child. When such a disorder occurs in the last trimester, there is a risk of developing fetal hypoxia, which can lead to serious complications at the time of birth.

If the deficiency of red blood cells nevertheless develops into even a mild degree of anemia, complications are possible that will affect the health of the pregnant woman.

The determination of the total number of red blood cells occurs during a routine general blood test. Through the same study, the rate of their subsidence is determined, which is an important factor.

Normal red blood cell counts depend on what trimester the expectant mother is in:

Thus, in the first trimester, indicators ranging from 4.2 to 5.4 million in 1 μl are considered normal.
In the second they range from 3.5 to 4.8 million.
In the third - from 3.5 to 7 million.

A low level of red blood cells can become high in cases where a pregnant woman has severe toxicosis. This is considered the absolute norm, and usually does not cause concern among specialists.

The main purpose of red blood cells is to transport oxygen to all tissues and remove carbon dioxide. Blood cells have a rich red hue due to the presence of hemoglobin. Red blood cells in pregnant women undergo constant and intensive renewal, since the child’s breathing inside the womb depends on this.

When conducting a clinical blood test, the volume of blood cells is determined and expressed in hematocrit value. The percentage norm should be no less than 36% and no more than 42%. Before conception, this indicator fluctuates depending on the monthly cycle. The maximum parameters are observed at the beginning, and closer to the middle, during the period of ovulation, the volume gradually decreases.

Red blood cells in the blood during pregnancy vary depending on the period. Immediately after conception, the number of blood cells is small, but as the embryo grows, the concentration gradually increases due to the appearance of a second circle of blood circulation around the baby. At the beginning, the blood contains 4.2-5.4 million cells, but already the 3rd trimester is characterized by 3.7-5.0 million per 1 μl. If a woman is susceptible to toxicosis, then the parameters are significantly reduced due to dehydration. Minor fluctuations and deviations in the number of red blood cells in the analysis are not considered a pathology, since while carrying a baby, the woman’s body undergoes hormonal changes and experiences high stress, which certainly affects the research results.

The main reasons for the decrease in the number of red blood cells

Frequent ARVI and taking antibiotics are the cause of erythropenia

In addition to physiological or “false” anemia, there are a number of other reasons why the number of blood cells may become smaller. The term “erythropenia” is used to refer to the lack of red blood cells in human blood. The main reasons for its occurrence in pregnant women include:

iron deficiency in the mother’s body (iron atoms are part of hemoglobin and are directly involved in the transport of oxygen);
infectious diseases;
disruptions in the functioning of the endocrine system;
decreased immunity due to chronic maternal diseases;
antibacterial therapy;
renal failure;
significant blood loss (the body launches compensatory mechanisms, trying to replenish blood volumes, and the concentration of red blood cells is restored much more slowly);
cancer (including leukemia - blood cancer);
general exhaustion of the body caused by stress or recent childbirth;

The expectant mother should remember that the best prevention of erythropenia is a planned pregnancy, which was preceded by the necessary preparations: health monitoring, courses of vitamins, etc. If symptoms of erythropenia appear, it is important to begin treatment as quickly as possible in order to protect yourself and the child from unpleasant consequences.

Normal limits

Significant hematological changes during pregnancy are physiological anemia, neutrophilia, mild thrombocytopenia, increased coagulation factors and decreased fibrinolysis.
By 6-12 weeks of pregnancy, blood plasma volume increases by approximately 10-15%. The fastest rate of increase in blood plasma volume is observed in the period from 30 to 34 weeks of pregnancy, after which plasma volume changes slightly.
The number of red blood cells begins to increase at 8-10 weeks of pregnancy and by the end of pregnancy increases by 20-30% (250-450 ml) relative to the normal level for non-pregnant women at the end of pregnancy A significant increase in plasma volume relative to the increase in hemoglobin and red blood cell volume leads to a moderate decrease hemoglobin level (physiological anemia of pregnant women), which is observed in healthy pregnant women.
Pregnant women may experience a slight decrease in platelet counts compared to healthy, non-pregnant women.
The neutrophil count begins to rise in the second month of pregnancy and stabilizes in the second or third trimester, at which time the white blood cell count. The absolute number of lymphocytes does not change.
Levels of some blood clotting factors change during pregnancy.

This article describes the hematological changes that occur during pregnancy, the most important of which are:

Increase in blood plasma volume and decrease in hematocrit
Physiological anemia, low hemoglobin
Elevated white blood cells during pregnancy
Neutrophilia
Moderate thrombocytopenia
Increased procoagulant factors
Reduced fibrinolysis

Changes in a woman’s body during pregnancy can lead to the development of phenomena that are unusual for her, including a decrease in the level of red blood cells.

It is worth noting that this is not so rare. According to statistics, during pregnancy, red blood cells in the blood are low in 40% of women! And it's very easy to explain. During pregnancy, the total volume of blood in the body increases. Its liquid part does this faster than formed elements (erythrocytes, leukocytes, etc.). In this case, experts talk about a false decrease in the level of red blood cells.

But there are also pathological reasons for a decrease in the level of red blood cells in expectant mothers. We will talk about them a little below.

A general blood test in pregnant women should show approximately the following results:

In the first trimester (*1012 / l) – 3.5-5.4;
In the second trimester (*1012 / l) – 3.2-4.8;
In the third trimester (*1012 / l) – 3.5-5.0.

By the way, in non-pregnant women the norm of red blood cells in the blood is in the range (*1012 / l) 3.9-4.7.

Red blood cells during pregnancy, ESR during pregnancy

The number of red blood cells begins to increase at 8-10 weeks of pregnancy and by the end of pregnancy it increases by 20-30% (250-450 ml) relative to the normal level for non-pregnant women, especially in women who took iron supplements during pregnancy. Among pregnant women who did not take iron supplements, the number of red blood cells may increase only by 15-20%. The lifespan of red blood cells decreases slightly during normal pregnancy.

The level of erythropoietin during normal pregnancy increases by 50% and its change depends on the presence of pregnancy complications. An increase in plasma erythropoietin leads to an increase in the number of red blood cells, which partially meet the high metabolic oxygen requirements during pregnancy.

In women who do not take iron supplements, the average volume of red blood cells decreases during pregnancy and in the third trimester averages 80-84 fL. However, in healthy pregnant women and in pregnant women with moderate iron deficiency, the average volume of red blood cells increases by approximately 4 fL.

ESR increases during pregnancy, which has no diagnostic value.

Why are red blood cells low during pregnancy?

Low red blood cells in the first three months of pregnancy are considered a normal phenomenon, which is associated with the fact that the volume of blood increases due to the liquid component, and the formed elements do not yet have time to be produced in large quantities, so indicators appear below normal. Also, this condition is allowed when fluid is retained in the body, when edematous reactions occur. If the red blood cells in the blood are low, then anemia and a lack of hemoglobin are automatically diagnosed, which poses a danger to the formation of the internal organs of the embryo. In this case, additional tests will be ordered to find out the reasons for the development of the pathology. Low indicators may occur as a result of the following factors:

Poor nutrition (lack of iron, folate or B vitamins);
blood loss of various types;
diseases of internal organs (kidneys, liver, heart);
inflammatory and infectious processes;
oncological diseases (tumors, leukemia);
emotional instability and fatigue;
hormonal deficiency.

If a short period of time has passed between the first birth and the second conception, then this often affects the fact that red blood cells are reduced, so it is recommended to plan the next pregnancy no earlier than in 3-3 years.

In addition, the 2nd trimester may be caused by the appearance of antibodies to red blood cell antigens. An immunological conflict arises due to the incompatibility of the blood of the woman and the fetus according to the Rh factor (the mother is Rh positive, the baby inherited it from the father - negative), thus, hemolytic disease develops in the child.

Features of the condition

Low red blood cells during pregnancy are a fairly common condition that affects up to 40% of all women during this period. Its main reason is an increase in the amount of fluid in the pregnant woman’s body due to its retention, which makes the blood dilute. In this case, the level can drop to 3 million microliters, which is normal. But a drop below this indicator under the influence of other factors can cause significant harm to the mother and fetus.

A decrease in red blood cells may indicate the development of anemia, although, unlike a drop in hemoglobin, this is not a mandatory sign of anemia. The specific type of anemia is determined by other indicators, for which additional tests are prescribed. Thus, iron deficiency in the blood lowers hemoglobin levels, which is especially dangerous during the first trimester, when the child’s internal organs begin to form.

Decreased red blood cells in the later stages lead to fetal hypoxia.

Why are red blood cells elevated during pregnancy?

Increased red blood cells in the blood during pregnancy provoke oxygen starvation in the child inside the womb. Due to high density indicators, the transport function is disrupted, blood circulation slows down and stagnates, and the risk of thrombosis increases. During the study, a hematocrit is determined above 45%, which is an indication for blood thinning in a hospital setting. With a slight increase in parameters, it is necessary to replenish the lack of fluid by consuming large amounts of clean water. The reasons for high indicators also include:

cardiovascular failure;
kidney, liver and lung diseases;
obesity;
smoking.

Stressful situations affect all parameters of any tests during pregnancy, so you need to take care not only of your physical condition, but also surround yourself with only positive emotions in order to reduce the risk of developing pathologies.

Elevated

A high level of red blood cells in the blood should be expected if:

Emotional shock was suffered;

Regular physical activity is carried out;

The place of residence is located in the mountains;

Heat.

An increase in the concentration of red cells as a result of toxicosis and dehydration is not considered a pathology, since it is associated with functional changes, and the volume of blood plasma decreases. Therefore, such erythrocytosis is considered a relative value and cannot be taken into account.

If the red blood cells in the results form are elevated, this may be a symptom of the development of diseases:

Of cardio-vascular system;
Kidney failure;
Liver dysfunction;
Diseases of the respiratory system.

Many people mistakenly believe that an increased level of red blood cells during pregnancy will provide the baby with more oxygen. Everything is completely wrong. With such indicators, the blood becomes thicker, which means its transport ability slows down. As a result, only remnants of oxygen will reach the baby, most of which will be processed and oxidized along the way. All this can develop fetal hypoxia.

Signs and causes of decreased red blood cell levels

Low red blood cells in the blood during pregnancy can result from a number of reasons:

irrational or improper nutrition;
large blood losses suffered before pregnancy;
problems with the heart, liver, kidneys;
anemia;
iron deficiency;
deficiency of vitamins in the body, in particular group B;
the presence of a chronic focus of inflammation;
infectious diseases;
parasitic diseases;
autoimmune diseases;
exhaustion that was caused by problems in the field of neurology;
frequent stress;
a small gap between the previous and current pregnancies;
hormonal imbalances;
the presence of cancer tumors at the metastasis stage;
taking certain types of medications;
leukemia;
destruction of erythroid cells.

All these pathologies will noticeably affect not only the health of the pregnant woman herself, but also the body of the not yet fully formed fetus.

A pregnant woman should worry if she begins to notice some deterioration in her condition.

They usually appear in such moments as:

unreasonable weakness;
constant lethargy;
a desire to sleep that occurs immediately after getting up in the morning;
decreased blood pressure;
chronic fatigue;
skin that is pale and dry;
some inhibition in actions;
Unreasonable fainting.

If there are at least a few symptoms, a pregnant woman should immediately contact a specialist managing the pregnancy.

Carrying out research for such symptoms is necessary to prevent possible excesses in the course of pregnancy and intrauterine development of the fetus.

If such a pathology is observed when a woman is in an “interesting” position, the reasons for its appearance are usually the following:

inadequate and irrationally structured nutrition;
large volumes of blood loss experienced before pregnancy;
pathologies of the functioning of the heart, kidneys and liver;
any type of anemia;
lack of iron in the body;
lack of folate;
lack of vitamin substances belonging to group B;
the existence of a focus of a certain inflammatory process that is chronic;
diseases of parasitic and infectious types;
cancer tumors, stage of active metastasis;
autoimmune diseases;
exhaustion of a neurological nature;
a small gap between the first, second and subsequent pregnancies;
leukemia;
taking certain medications;
disruptions of a hormonal nature;
destruction of erythroid cells.

Any of the above pathologies can become a serious problem for a pregnant woman. And this, in turn, will cause the development of various syndromes, diseases, and unformed fetuses. For this reason, taking care of your own health while carrying a child is the primary task of the expectant mother.

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.

When to sound the alarm?

During pregnancy, low red blood cells can be detected only after a blood test. However, there are several signs that can indicate the presence of a problem and alert a woman:

constant lethargy;
causeless weakness;
drowsiness and desire to go to bed immediately after getting up in the morning;
chronic fatigue;
lowering blood pressure;
dry and pale skin;
inhibited reactions;
fainting states.

The presence of at least several symptoms from the list is a reason to urgently consult a specialist! Timely provision of assistance can relieve various problems in the course of pregnancy and fetal development.

Risk to the fetus

With low red blood cells in the expectant mother, the risk to the fetus is always high and complications against this background are quite common. Therefore, it is very important for a woman who had similar problems before pregnancy to get rid of such a diagnosis even before conception. Low red blood cells in the blood during pregnancy, in its early stages, can provoke improper placement of the placenta. Underdevelopment or blocking of the entrance to the uterus by the placenta occurs. This in turn leads to termination of pregnancy, hypoxia or underdevelopment of the fetus.

Find out more about such examinations during pregnancy as: homocysteine, blood test for AFP, PAPP-A test, screening (first and second), glucose tolerance test, coagulogram, hysteroscopy, colposcopy, Zimnitsky test, D-dimer, CTG, anti-Mullerian test hormone, CTE, RFMC, Doppler ultrasound, homocysteine and fluorography.

Newborns from such women may have a number of problems:

developmental disorders;
low body weight;
underdevelopment of the respiratory system;
developmental delay, both physically and intellectually.

In addition, there is a risk of death in the first days after birth.

How to prevent low red blood cell levels

People say: “Forewarned is forearmed.” This saying also applies to pregnant women, whose red blood cells are significantly reduced from the first weeks.

In order to prevent their level from decreasing even further, it is enough to follow all the recommendations of obstetricians and gynecologists: the rules are to prevent the occurrence of such conditions.

The main preventive measures include:

Constant control over the level of erythroid cells. It involves passing the necessary tests to conduct the study.
The right approach to organizing a balanced diet (foods rich in iron, copper, folic acid, juice therapy, drinking herbal teas).
Complete cessation of bad habits, alcohol, smoking, drugs;
Moderate physical activity is acceptable for pregnant women.

The same day a woman learns about her wonderful position as an expectant mother, she must take care of herself for the benefit of the development of the child in her womb. For this reason, it is necessary to take medications containing vitamin and mineral complexes (especially groups A and C), take the necessary tests on time, and also listen to all recommendations of obstetricians. All this is done for the sake of the health of the expectant mother, as well as the new member of society.

You shouldn’t think that low red blood cells in the blood during pregnancy is not such a big problem. This phenomenon can cause the development of dangerous complications.

A decrease in red cells in the early stages can lead to improper formation of the baby’s internal organs, the development of various pathologies, and even termination of pregnancy.

In the last trimester, a decrease in red blood cells in women increases the risk of developing fetal hypoxia, complications during the birth process (weak labor, external hemorrhages), and infant death within the first days after birth.

The pathology also affects the well-being of the expectant mother (all possible symptoms were discussed above).

What causes low red blood cells during pregnancy? Causes and methods of normalizing red blood cells

During the period of bearing a baby, a woman’s body is rebuilt and begins to work completely differently, and the changes also affect the biochemical composition of some biological fluids. Very often red blood cells are low during pregnancy.

If red blood cells are low during pregnancy, is this normal? This question worries many women who are happily awaiting the birth of their babies. What does it mean if red blood cells are low, how dangerous is this phenomenon?

A general blood test is mandatory for all expectant mothers. Doctors usually recommend undergoing this examination after a woman’s first visit to a medical facility. After receiving the test results, it may be revealed that red blood cells are low. These cells are also called red blood cells. They perform a number of important functions. One of the most important is oxygen transfer. Toxins, proteins, and fat molecules can be adsorbed on their surface.

If red blood cells are low in a pregnant woman, anemia develops. This is a very serious disease that can lead to certain consequences. For all organs and systems to function normally, the amount of oxygen must be sufficient. When red blood cells are low, cellular respiration is impaired. This can have a detrimental effect on the course of pregnancy. If the concentration of red blood cells in the blood of the expectant mother is very low, the baby suffers from a lack of oxygen. This leads to intrauterine growth retardation and can even provoke placental abruption and hypoxia.

Why do pregnant women often face this problem? During this period, fluid is retained in the woman’s body, metabolism is disrupted, the blood thins and, accordingly, the concentration of red blood cells in it becomes lower. There are special tables by which the doctor can assess how serious the deviation from the norm is. If it is mild, there is no need to worry.

When the number of red blood cells per unit volume of blood decreases to 3 million cells or below, this can be considered a serious reason to sound the alarm. The reasons for the low content of red blood cells in biological fluid can be different. The most common are:

- blood loss;

- poor formation of red blood cells;

- hereditary factor;

- infectious diseases;

— autoimmune diseases;

- iron deficiency.

Blood loss during pregnancy can be associated with both trauma and placental abruption. In the latter case, immediate medical intervention is necessary. Blood loss can be a serious risk.

Often, a decrease in the concentration of red blood cells is associated with serious hemolytic diseases. A woman may not even know about the existence of a particular pathology. During pregnancy, all diseases usually worsen and are detected after the next examination.

Dangerous infectious diseases such as whooping cough and diphtheria can change the composition of the blood. Usually they are far from asymptomatic. It is necessary to first cure the underlying disease, and only then focus on the result of a blood test. Usually, after complete recovery, the concentration of red blood cells in the biological fluid increases. The difficulty may lie in the fact that pregnant women cannot take many medications. Some drugs can even cause anemia, so after receiving unsatisfactory test results, a woman needs to remember what medications she took and tell her doctor about it.

A deficiency of red blood cells can also be caused by poor nutrition. Usually, to make a diagnosis such as anemia, experts suggest that a woman undergo additional tests to determine the color index of the blood and the quantitative content of hemoglobin in red blood cells. For example, hyperchromia usually occurs against the background of folic acid deficiency. This vitamin should be supplied to the pregnant woman's body in sufficient quantities throughout the first trimester. Experts also recommend starting to drink it a couple of months before the expected conception. A lack of folic acid can lead to the development of neural tube defects in the baby and other pathologies. In this case, it is very important to detect this problem in time by taking a blood test.

A decrease in the concentration of red blood cells in biological fluid is always associated with iron deficiency. This microelement is necessary for pregnant women, therefore, after discovering its deficiency, a woman must be prescribed special iron-containing preparations. While expecting a baby, the need for iron increases significantly, so hypochromia among expectant mothers is a fairly common phenomenon. It may be associated not only with a deficiency of the microelement, but also with a violation of the mechanism of its absorption into the walls of the gastrointestinal tract.

Diseases of internal organs and systems can lead to changes in blood composition. Most often, the cause of such a deviation is a malfunction of the liver and spleen. To improve the result of a blood test, you need to establish the cause of the decrease in red blood cell concentration and try to eliminate it. The doctor can also prescribe vitamin and mineral complexes to the patient and recommend a diet. To prevent fetal hypoxia, pregnant women need to spend more time in the fresh air.

When a pregnant woman's red blood cells are low, this can be considered normal, but only to a certain limit. A sharp change in the biochemical composition of the blood may indicate the development of pathologies and pose a danger to the health of the woman and her baby.

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Blood plasma volume

By 6-12 weeks of pregnancy, blood plasma volume increases by approximately 10-15%. The fastest rate of increase in blood plasma volume is observed in the period from 30 to 34 weeks of pregnancy, after which plasma volume changes slightly. On average, blood plasma volume increases by 1100-1600 ml per trimester, and as a result, plasma volume during pregnancy increases to 4700-5200 ml, which is 30 to 50% higher than plasma volume in non-pregnant women.

During pregnancy, plasma renin activity tends to increase, while the level of atrial natriuretic peptide decreases slightly. This suggests that the increase in plasma volume is caused by vascular insufficiency, which is caused by systemic vasodilation (dilation of blood vessels throughout the body) and an increase in vascular capacity.

Since it is the volume of blood plasma that initially increases, its effect on the renal and atrial receptors leads to opposite effects on hormonal levels (a decrease in plasma renin activity and an increase in natriuretic peptide). This hypothesis is also supported by the observation that increasing sodium intake does not further increase plasma volume.

After delivery, plasma volume decreases immediately but increases again after 2–5 days, possibly due to increased aldosterone secretion occurring at this time. Plasma volume then gradually declines again: at 3 weeks postpartum it is still elevated by 10-15% relative to the normal level for non-pregnant women, but is usually completely normal by 6 weeks postpartum.

Urinalysis for erythrocyturia

Low red blood cells in the blood and what this means in women is a very important question that worries every expectant mother. However, along with decreased red blood cells, there is an increase in blood cells in the body, namely in the urine. This diagnosis is called erythrocyturia.

Laboratory tests are used to determine the number of red blood cells in urine.

Important! Normally, from 0 to 3 cells are detected in the field of view. Exceeding this indicator indicates the presence of the disease.

Therefore, for a more accurate diagnosis and the reasons for the occurrence of such an anomaly, a urine test is performed using three test tubes.

The essence of the analysis lies in a special method of collecting urine. During one trip to the toilet you need to use three containers in turn.

Based on the number of red blood cells in each container, certain conclusions are drawn:

the most blood cells in the first jar means problems with the urinary tract; Moreover, in each subsequent test tube their number will be less;
exceeding the norm in the third container indicates the presence of pathologies in the bladder, since it is from there that the last portion of urine is released;
the same amount in all three containers indicates problems in the kidneys.

Treatment

Before prescribing treatment for low red blood cells in the blood during pregnancy, the doctor will refer the patient for a repeat blood test. This will help eliminate a possible error or once again confirm the problem. A pregnant woman will have to follow a few simple rules before taking the test:

avoid emotional turmoil;
minimize physical activity;
Do not eat new or unhealthy foods for 24 hours.

You need to take the test in the morning, on an empty stomach (at least 10 hours must pass after eating). At the same time, you are allowed to drink clean still water.

The treatment regimen will depend on the cause that provoked the decrease in red blood cells during pregnancy. If it was an unbalanced diet or an inactive lifestyle, the specialist will give the woman general recommendations regarding diet and permitted physical activity.

A pregnant woman's diet should contain a sufficient amount of vitamins and minerals. Don't give up daily walks in the fresh air.

For infectious and other diseases, the main focus is on their treatment. The level of red blood cells, in this case, will have to recover on its own.

If the problem is associated with severe blood loss, specialists will select special therapy to quickly restore the patient’s body. These can be various iron-containing preparations and vitamins that will promote hematopoiesis. In addition, such patients will be advised to drink more fluids and introduce foods with a high iron content into their diet: dried mushrooms, beef liver, cocoa, green beans, strawberries, blueberries, beef, rabbit, carrots, eggs.

If there are serious health problems, such as anemia or malignant neoplasms, the pregnant woman will be treated in a hospital setting and under the constant supervision of medical personnel.

Preparing and conducting analysis

On average, a pregnant woman undergoes a clinical blood test every month. Passing it is considered standard procedure.

To do this, in the morning (before 10.00) capillary blood is taken from a finger. The results, as a rule, are ready the next day and are transferred to the gynecologist leading the pregnancy.

There are a number of preparatory activities, the implementation of which will help to obtain a more accurate result:

The analysis is carried out on an empty stomach. The last meal is dinner, 8-10 hours before the analysis;
On the eve of collecting biomaterial, you can only drink water;
The intake of medications and vitamin complexes is suspended. If it is impossible to comply with this point, consult your doctor, he may change the dosage;
Physical and emotional stress on the body is reduced to a minimum.

Iron requirement

In a singleton pregnancy, the iron requirement is 1000 mg per pregnancy: approximately 300 mg for the fetus and placenta and approximately 500 mg, if present, to increase hemoglobin. 200 mg is lost through the intestines, urine and skin. Since most women do not have adequate iron stores to meet their needs during pregnancy, iron is usually prescribed in a multivitamin or as a separate element. In general, women taking iron supplements have a hemoglobin concentration that is 1 g/dL higher than women not taking iron.

The daily folate requirement for non-pregnant women is 50-100 mcg. An increase in the number of red blood cells during pregnancy leads to an increase in the need for folic acid, which is ensured by increasing the dose of folic acid to 400-800 mcg per day to prevent neural tube defects in the fetus.

Stabilization methods

Red blood cells are below normal and we have already looked at what this means during pregnancy. At this stage, we will pay attention to methods of stabilization and treatment of this phenomenon.

When diagnosing a small number of blood cells in the body of a future woman in labor, the doctor conducts a number of studies in order to discover the cause of such an anomaly. Once the original source of the disease is discovered, the necessary treatment is prescribed.

State stabilization is performed in the following ways:

changing the diet, which increases the amount of nutrients and vitamins;
if the cause of this condition was an infection, the source of inflammation is treated with additional immunotherapy;
hyperhydration is eliminated by taking urinary medications; Also, at the same time, exclude from the diet foods that retain water in the body;
in case of blood loss, they stabilize the condition by replenishing the required level and composition of blood.

More serious pathologies in the form of cancer, anemia, and other things are stabilized in a hospital setting under the supervision of a doctor.

Traditional methods

The deficiency of red blood cells can also be eliminated using effective folk methods. Before using them, you should consult your doctor!

Infusions and decoctions of medicinal plants are highly effective in combating the problem: lungwort, strawberry leaves, rose hips, burnet rhizomes. They need to be taken twice a day.

We must not forget that folk remedies can also have side effects. For example, strawberry leaves can lower already low blood pressure. Therefore, a pregnant woman should be as careful as possible. Also, such medications can be used for no more than three months, after which it is important to take a break.

A mixture of nuts, dried fruits and honey copes well with the problem. You need to mix walnuts, dried apricots, prunes and honey in equal proportions. The mixture should be eaten two teaspoons three times a day.

Prevention

The day a woman learns about her interesting situation, she must understand that from that moment she is also responsible for the health of her unborn baby. Therefore, in no case should you refuse to take tests that are regularly prescribed by a specialist. It is also equally important to do everything possible to protect yourself as much as possible from a decrease in the number of red blood cells in the blood. The following will help in this matter:

a balanced diet, which includes eating foods rich in iron, folic acid, copper and other beneficial substances;
giving up alcohol, smoking and other bad habits;
moderate physical activity;
timely diagnosis and treatment of various diseases.

Finally, it is worth reminding once again that expectant mothers during pregnancy should treat their health with special care, promptly seek help from a doctor and take all tests prescribed for them on time.

Causes of erythropenia

There are the following reasons for low levels of red blood cells in the body:

Posthemorrhagic anemia , developing as a result of acute (manifest) or chronic blood loss. Manifest bleeding occurs as a result of injury, accompanied by a violation of the integrity of large vessels. Chronic bleeding is characteristic of the destruction of the vessel wall due to a stomach ulcer or inflammation of hemorrhoids. Heavy menstruation. With large blood loss, a state of hemorrhagic shock occurs, accompanied by a rapid drop in pressure and organ failure;
Insufficient reproduction of red blood cells. The causes of this erythropenia are the lack of components for the construction of red blood cells, namely cyanocobalamin, iron, and folic acid. Deficiency develops in case of insufficient intake of these elements from food, or their improper absorption due to malfunctions of the intestines;
Increased destruction of red blood cells . The lifespan of cells is about four months, but with certain genetic abnormalities, the hematopoietic organs generate defective cells that die before the appointed time. The death of red blood cells is provoked by pathogen toxins, disrupting the functioning of the bone marrow. Protozoan parasites that enter the bloodstream through a mosquito bite feed on red blood cells;
Malignant tumors developing in the bone marrow or entering it during metastasis paralyze the functioning of the organ and stop the reproduction of red blood cells;
Systemic connective tissue diseases provoke the production of antibodies to red blood cells by immune cells;
Certain medications and chemotherapy can cause erythropenia (anemia).

Thrombocytopenia during pregnancy

In most cases, the platelet count during an uncomplicated pregnancy remains within the normal range for non-pregnant women, but pregnant women may also have a lower platelet count compared to healthy non-pregnant women. The platelet count begins to rise immediately after delivery and continues to increase for 3-4 weeks until it returns to normal.

The most obstetrically important change in platelet physiology during pregnancy is thrombocytopenia, which may be associated with pregnancy complications (severe preeclampsia, HELLP syndrome), drug disorders (immune thrombocytopenia), or may be gestational thrombocytopenia.

Gestational or accidental thrombocytopenia occurs asymptomatically in the third trimester of pregnancy in patients without previous thrombocytopenia. It is not associated with maternal, fetal or neonatal complications and resolves spontaneously after delivery.

Leukocytes during pregnancy

During pregnancy, leukocytosis is observed, mainly associated with an increase in circulating neutrophils. The number of neutrophils begins to increase in the second month of pregnancy and stabilizes in the second or third trimesters, at which time the number of leukocytes increases from 9*10^9/l to 15*10^9/l. The white blood cell count decreases to the reference interval for non-pregnant women by the sixth day after delivery.

In the peripheral blood of pregnant women there may be a small number of myelocytes and metamyelocytes. According to some studies, there is an increase in the number of young forms of neutrophils during pregnancy. Lobular bodies (blue staining of cytoplasmic inclusions in granulocytes) are considered normal in pregnant women.

In healthy women during uncomplicated pregnancy, there is no change in the absolute number of lymphocytes and no significant changes in the relative number of T and B lymphocytes. The number of monocytes usually does not change, the number of basophils may decrease slightly, and the number of eosinophils may increase slightly.

Clotting factors and inhibitors

During normal pregnancy, the following changes in the levels of coagulation factors occur, leading to physiological hypercoagulability:

Due to hormonal changes during pregnancy, the activity of total protein S antigen, free protein S antigen and protein S decreases.
Resistance to activated protein C increases in the second and third trimesters. These changes were detected in first-generation tests using pure blood plasma (i.e., not lacking factor V), but this test is rarely used clinically and is of only historical interest.
Fibrinogen and factors II, VII, VIII, X, XII and XIII increase by 20-200%.
The von Willebrand factor increases.
The activity of fibrinolysis inhibitors, TAF1, PAI-1 and PAI-2 increases. The level of PAI-1 also increases noticeably.
Levels of antithrombin III, protein C, factor V and factor IX most often remain unchanged or increase slightly.

The end result of these changes is an increased tendency to thrombus formation, an increase in the likelihood of venous thrombosis during pregnancy and, especially, in the postpartum period. Along with myometrial contraction and increased tissue decidual factor levels, hypercoagulability protects the pregnant woman from excessive bleeding during labor and placental separation.

APTT remains normal throughout pregnancy but may decrease slightly. Prothrombin time may be shortened. Bleeding time does not change.

The timing of normalization of blood clotting activity in the postpartum period may vary depending on factors, but everything should return to normal within 6-8 weeks after birth. The hemostasiogram does not need to be assessed earlier than 3 months after birth and after completion of lactation to exclude the influence of pregnancy factors.

https://www.youtube.com/watch?v=EenYDnE4HQU

The influence of factors of acquired or hereditary thrombophilia on pregnancy is an area for research.