Determination of Morphological and Physiological Classification of Anemias among Sudanese Pregnant Women in Khartoum State

Abstract

This is a cross sectional descriptive analytical study carried out on Umbadda hospital and Alsuadi maternal hospital in the period from January 2011 to May 2011 to evaluate the complete blood count (CBC) and reticulocyte count in Sudanese anemic pregnant women. A total of 100 anemic pregnant women as study group and 50 pregnant women as control group aged from 15-40 years were selected. Blood sample was collected randomly from each pregnant woman during different gestational age. 2.5ml venous blood was placed in K3 EDTA containers for CBC which was performed using automated analyzer (sysmex KX 21N), thin blood film preparation and manual reticulocyte count. 52% of the pregnant ladies received iron treatment and 48% did not. They were studied also for chronic diseases as well as hematological changes. The results were analyzed by Statistical Package for Social Science (SPSS version 14.0) program and the mean of each parameter were calculated. They were as followed: The mean of RBCs count, HB and PCV were3.7×106/μl ±0.6, 9 g/dl ±1.6 and 27.7%±5 respectively. The mean of MCV was 73.8±9.2, MCH was 24.4±3.4 and MCHC was 33±2.8. The mean of TWBCs count was 8.3×103/μl ±2.3 and platelets was 212×103/μl ±65. All the parameters of the study group showed significant difference (P. value < 0.05) in compare with control group. When the study group divided into 3 different trimesters, there was significant difference (P. value < 0.05) in the hematological parameters. The study revealed that the morphological types of anemia in pregnant women were 52(52%) microcytic hypochromic, 37 (37%) normocytic normochromic and 11(11%) dimorphic picture. In the physiological classification based on RPI that reflect the bone marrow activity 91(91%) had ineffective erythropoiesis with RPI <2 and 9(9%) had effective erythropoiesis with RPI ≥2. The number of pregnancy showed significant effect on HB level in pregnant women while the chronic diseases showed insignificant effect on the level of HB. With progress of program, there is tendancy to anemia and increase RPI and microcytosis with hypochromasia. The cause of the anemia in this study is likely to be iron deficiency.