To improve accuracy, discard the first drop of blood and do not squeeze the finger because this makes tissue fluids contaminate the blood. Criteria for Anemia Hemoglobin and hematocrit values are normally Tower in pregnant than in nonpregnant women, and they reach the lowest values during the second trimester of pregnancy. The effects of altitude and smoking are additive. To avoid underdiagnosis of anemia at high altitude, add the appropriate value from this table to the cutoff value given in Table 1 or 2 in Tab 1, page 16. Indications for AcIditional Testing Serum FemLin.
Serum ferritin provides an estimate of iron reserves.
Iron Supplements Iron deficiency is the most common cause of anemia during pregnancy. Low-dose iron can be given alone or as part of a multivitaminlmineral supplement of appropriate composition for pregnancy Effective forms of iron inclucle ferrous sulfate, ferrous fumarate, and ferrous gluconate. Liquid and chewable forms are available for women who have trouble swallowing tablets or cap- suies. These iron preparations may stain teeth, but the stain can be removed by brushing. Recommenc3 taking the supplement at bedtime or between meals with water or juice, not with milk, tea, or coffee.