Iron deficiency anemia; red cell distribution width [RDW] and red cell indices in the prediction of among healthy women in third trimester of pregnancy

ABSTRACT

To determine the importance of the RDW and other red cell indices [MCV, HBG] in the prediction of iron deficiency anemia in third trimester of pregnancy in a tertiary care hospital of Peshawar. Cross sectional study. OPD Department of Gynecology and Obstetrics Postgraduate Medical Institute, Lady reading Hospital [PGMI-LRH] Peshawar. Period 1[st] August 2012- 10[th] Dec 2012. A Total of 152 women attending the centre were included. Necessary information's were recorded on the questionnaire prepared in accordance with the objectives of the study. A total of 152 women in their third trimester presenting to Gynecology and obstetrics department of Lady reading hospital Peshawar. The age range of the patient was from 20 years to 55 years with mean age of 33 +/- 3.4 years. Out of total 27[18%] were primagravida. Majority of the cases 118[77.6%] were from Peshawar, 9% from charsadda, 8% nowshera etc. We also received 2 patients 1.2% from Afghanistan. Regarding financial status 57%[87] females were in upper Class [i.e. income >20000/month] on recall. Of total 81[53%] of the females were having hemoglobin less than 11g/dl and 22% of the women had HCT<32% which as per criteria of the WHO were anemic at the time of presentation. While 29[19%] patients had low value of MCV [microcytic]. Fifty five patients [36.2%] had RDW CV[%] more than 15% which points more towards the microcytic nature of anemia and more anisocytosis. Fifty five patients [36.2%] had RDW CV[%] more than 15% which points more towards the microcytic nature of anemia. While 29[19%] patients had low value of MCV [microcytic]. Increased RDW is best indicator for the detection of iron deficiency anemia than MCV. Increased RDW even in the presence of normal MCV can be an early signal for iron deficiency anemia in pregnancy. Hence RDW is more reliable indicator for iron deficiency especially in pregnancy. Changes in RDW in last trimester is more significant that MCV