IRON DEFICIENCY ANEMIA

Objectives: 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 tertiarycare hospital of Peshawar. Design: Cross sectional study. Setting: OPD Department ofGynecology and Obstetrics Postgraduate Medical Institute, Lady reading Hospital (PGMI-LRH)st th Peshawar. Period: 1 August 2012- 10 Dec 2012. Material and Methods: A Total of 152 womenattending the centre were included. Necessary information’s were recorded on the questionnaireprepared in accordance with the objectives of the study. Results: A total of 152 women in theirthird trimester presenting to Gynecology and obstetrics department of Lady reading hospitalPeshawar. The age range of the patient was from 20 years to 55 years with mean age of33+3.4years.Out of total 27(18%) were primagravida. Majority of the cases 118(77.6%) werefrom Peshawar, 9% from charsadda, 8% nowshera etc. We also received 2 patients 1.2% fromAfghanistan. 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 than11g/dl and 22% of the women had HCT<32% which as per criteria of the WHO were anemic at thetime 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 ofanemia and more anisocytosis. Conclusions: Fifty five patients (36.2%) had RDW CV(%) morethan 15% which points more towards the microcytic nature of anemia. While 29(19%) patientshad low value of MCV (microcytic). Increased RDW is best indicator for the detection of irondeficiency anemia than MCV. Increased RDW even in the presence of normal MCV can be anearly signal for iron deficiency anemia in pregnacy. Hence RDW is more reliable indicator for irondeficiency especially in pregnancy. Changes in RDW in last trimester is more significant that MCV.