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Anemia is a condition in which blood has a lower-than-normal amount of red blood cells or hemoglobin. [1] Anemia in pregnancy is a decrease in the total red blood cells (RBCs) or hemoglobin in the blood during pregnancy. Anemia is an extremely common condition in pregnancy world-wide, conferring a number of health risks to mother and child. [2]
Fetal hemoglobin, or foetal haemoglobin (also hemoglobin F, HbF, or α 2 γ 2) is the main oxygen carrier protein in the human fetus.Hemoglobin F is found in fetal red blood cells, and is involved in transporting oxygen from the mother's bloodstream to organs and tissues in the fetus.
This removes adult hemoglobin, but not foetal hemoglobin, from the red blood cells. Subsequent staining, using Shepard's method, [ 5 ] makes fetal cells (containing foetal hemoglobin) appear rose-pink in color, while adult red blood cells are only seen as "ghosts". 2000 cells are counted under the microscope and a percentage of foetal to ...
Finally, anything which causes persistence of fetal hemoglobin in maternal blood cells will make interpretation much trickier. Certain hemoglobinopathies, the most common of which is sickle cell trait, do this. Overall, somewhere around 1–3% of the time this could result in false interpretation.
During pregnancy the plasma volume increases by 40-50% and the red blood cell volume increases only by 20–30%. [22] These changes occur mostly in the second trimester and prior to 32 weeks gestation. [24] Due to dilution, the net result is a decrease in hematocrit or hemoglobin, which are measures of red blood cell concentration.
Fetal hemoglobin can be used to screen for pregnancy complications in the fetus and pregnant person. Fetal hemoglobin can also be used to treat sickle cell anemia. This hemoglobin is less likely to be affected by the disease because it has a higher affinity for oxygen. Hydroxyurea is used to increase the amount of fetal hemoglobin in an adult. [4]
Hemoglobin Barts, abbreviated Hb Barts, is an abnormal type of hemoglobin that consists of four gamma globins. It is moderately insoluble, and therefore accumulates in the red blood cells. Hb Barts has an extremely high affinity for oxygen, so it cannot release oxygen to the tissue. Therefore, this makes it an inefficient oxygen carrier.
The hemoglobin alkaline denaturation test can detect the presence of maternal blood, which is indicated by a color change from red to brown when the sample is added to alkali reagent. [ 13 ] [ 14 ] Blood typing would also detect maternal blood, as the I antigen only occurs in adults. [ 12 ]