Abstract
Fetal development is accompanied by extensive changes in maternal body compositions and metabolism, and the severe anemia during pregnancy also has great influences not only upon the mother but also upon the fetus and the newborn. It is clear that clinical standards considered “normal” for the non-pregnant women cannot be used as standards for pregnant women because of the big hemodilution in pregnancy. By our observations, the hemoglobin concentration decreased on average by 14.0%, while the plasma volume and blood volume increased on average by 49.8% and 23.3%, respectively.
In an attempt to make a hematological standard for the gravid Japanese woman, measurments of the total hemoglobin and red cell mass were made on 112 pregnant women (IIIrd trimester) without any selection of cases, who were residents of Tokushima City. By using the statistical analysis, anemia of the gravid woman was defined as follows: the total hemoglobin below 9.0g/kg, and the red cell mass below 25ml/kg, taking a range of 2 S.D. from the mean. But these standards seemed not too convenient for the practical use for group examination of pregnant women.
Accordingly, the hemoglobin concentration less than 10.0g/dl in the venous blood was designed as anemia in pregnancy, since the highest correlation was found on it with the total hemoglobin and red cell mass. On the other hand, the red cell count and the hematocrit were found less usefull for the indicators of anemia in pregnancy. The incidence of anemia in pregnancy by this standard was 16.9% (35 women out of 206), and the anemia was of the normocytic, hypochromic type and was accompanied by low serum iron values.
