title: [Hemoglobin, iron deficiency and anemia in pregnant women. Diagnostic aspects].
abstract: Normal haemoglobin concentration in the trimesters of pregnancy can be considered to be 11-13 g/100 ml, 10-13 g/100 ml and 11-14 g/100 ml, respectively. High and low haemoglobin levels both indicate important pathophysiological changes. The authors discuss the use of serum-ferritin (S-ferritin), mean corpuscular volume (MCV) and erythrocyte protoporphyrin as diagnostic tools. S-ferritin, which is a reliable indicator of the iron status in the first trimester, becomes less reliable after the 20th week due to the physiological dilution of the plasma and a concurrent fall in haemoglobin and S-ferritin. Erythrocyte protoporphyrin is not influenced by the plasma dilution and can be used as a supplement to S-ferritin to assess iron deficiency. MCV can also be used to characterise the iron status. Decreases in MCV take time, however, which makes clinical interpretation difficult. S-ferritin measurement early in pregnancy is a reliable parameter for judging whether iron supplementation is necessary. Even if S-ferritin is influenced by the plasma dilution, a concentration below 15 microgram/l indicates iron deficiency in all stages of pregnancy.
authors.affiliation: Kvinneklinikken, Haukeland Sykehus, Bergen.
authors.forename: K
authors.initials: K
authors.lastname: Haram
authors.forename: T
authors.initials: T
authors.lastname: Hervig
authors.forename: R J
authors.initials: RJ
authors.lastname: Ulvik
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis*; D000748:Anemia, Macrocytic / Q000097:blood / Q000175:diagnosis*; D004909:Erythrocyte Indices; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007501:Iron / Q000097:blood; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood* / Q000175:diagnosis
chemical_list: D006454:Hemoglobins; D005293:Ferritins; D007501:Iron
vernacular_title: Hemoglobin, jernmangel og anemi hos gravide. Diagnostiske aspekter.