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Therefore, hemoglobin deficiency, especially in pregnant women, can cause serious disruption in the health of both mother and child.

Such a complex structure of hemoglobin and provides its main function in the transfer of oxygen and maintenance of cellular respiration. It is the trace element of trivalent iron that attaches an oxygen molecule, and then gives it to the cell during oxidation. The hemoglobin molecule itself contains a globin protein on which the heme is configured - it is a complex prostacyclic compound that contains in the center an iron molecule. Erythrocytes provide the transfer of the oxygen molecule from the lungs to all cells of the female body precisely due to the content of hemoglobin in its composition. If applied nationally, the savings would amount to $100 million per year.Hemoglobin is the main component of erythrocytes - red blood cells. The potential savings would be between $22 and $39 per patient, depending on whether hemoglobin and hematocrit measurements or a complete blood count is ordered. If hemoglobin and hematocrit values are acceptable at that time, retesting later in pregnancy is not necessary in low-risk pregnant women. The authors concluded that the screening performed at 26 to 28 weeks of gestation occurs at the physiologic nadir of blood values in pregnancy. Management plans were not changed in any patient because of concerns about mild anemia. More than 80 percent of the women who were anemic at 26 to 28 weeks of gestation were no longer anemic on admission at term, in spite of the low compliance with therapy.

Only four of the 20 women who were anemic at 26 to 28 weeks of gestation were still anemic at term. Fewer than one half of the women reported taking the supplement.īy the time the women were admitted in labor, the mean hemoglobin and hematocrit values had increased by a mean of 0.5 g per dL (5 g per L) and 2.8 percent (0.03), respectively. The 20 mothers who had hemoglobin levels below 10 g per dL (100 g per L) or a hematocrit level below 30 percent (0.30) at 26 to 28 weeks of gestation were provided with 325 mg per day of ferrous sulfate. More than 80 percent of the women reported taking the vitamins. All of the women were provided with prenatal vitamins the university clinic vitamins contained 65 mg of iron and 1.0 mg of folate. Prenatal care was provided by the university clinic for 75 percent of the women, and the remainder received care at local health departments. Approximately two thirds of the women were Medicaid recipients. The racial demographics were 40 percent black, 30 percent white, and 30 percent Hispanic. The average age of the women was 24 years, and 64 percent were multigravidas. In addition to gathering data on the pregnant women, the authors interviewed 31 obstetric specialists from the unit to identify the hemoglobin and hematocrit values at which patient management decisions would be affected. Women with preterm delivery and pregnancies complicated by hemoglobinopathies, hypertension, or multiple gestation were excluded. In these women, hemoglobin and hematocrit measurements were obtained on admission and at 26 to 28 weeks of gestation.

The study included 101 consecutive women admitted in labor at term to a hospital labor and delivery unit. In their study, they evaluated the ability of hemoglobin and hematocrit measurements at 26 to 28 weeks of gestation to predict values during labor. Around this time, testing for anemia is usually conveniently performed when blood is drawn for hyperglycemia screening. They argued that the physiologic changes of pregnancy result in the lowest hemoglobin and hematocrit values at 26 to 28 weeks of gestation. Sherard and Newton questioned the need for this testing if screening for anemia during pregnancy is normal. Hemoglobin and hematocrit measurements are performed in almost all women admitted to a hospital in labor.