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

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 tertiary
care hospital of Peshawar. Design: Cross sectional study. Setting: OPD Department of
Gynecology 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 women
attending the centre were included. Necessary information’s were recorded on the questionnaire
prepared in accordance with the objectives of the study. Results: 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+3.4years.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. Conclusions: 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 pregnacy. Hence RDW is more reliable indicator for iron
deficiency especially in pregnancy. Changes in RDW in last trimester is more significant that MCV.