A pregnant woman diagnosed with severe Anemia \[HB< 7 gm/dl] will be treated by? - HPSSC - 2015

HPSSC - 2015

Obstetrics & Gynaecology

Medium

Appeared in: HPSSC - 2015

Explanation

A hemoglobin level below 7 g/dL in pregnancy constitutes severe anemia, a medical emergency.
Packed cell transfusion is the most rapid and effective method to increase the oxygen-carrying capacity of the blood.
This immediate intervention is necessary to prevent severe maternal complications like cardiac failure and fetal complications like hypoxia and distress.
Each unit of packed red blood cells (PRBCs) can raise the hemoglobin level by approximately 1 g/dL, providing rapid stabilization.

Option A: Oral iron and folic acid tablets are the standard treatment for mild to moderate anemia, but their effect is too slow for severe cases. It takes several weeks to raise hemoglobin levels significantly with oral therapy.
Option C: Intramuscular (I/M) iron injections are also too slow to correct severe, life-threatening anemia. Furthermore, they are painful, can cause skin staining, and carry a risk of anaphylactic reactions. Intravenous (IV) iron is now preferred over I/M when parenteral iron is needed.
Option D: While a diet rich in iron and vitamin C is important for preventing anemia and for long-term maintenance of iron stores, it is completely inadequate as a primary treatment for severe anemia. Dietary changes cannot raise hemoglobin levels quickly enough to manage this acute condition.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Management of severe anemia in pregnancy as background academic context rather than a clinical decision trigger.
Untreated severe anemia in pregnancy is associated with high risks of maternal mortality, pre-eclampsia, postpartum hemorrhage, and cardiac failure.
For the fetus, risks include intrauterine growth restriction (IUGR), preterm birth, low birth weight, and even intrauterine death.
Nursing responsibilities during a blood transfusion are critical: verifying patient identity and blood product, monitoring vital signs before, during, and after the transfusion, and observing for any signs of a transfusion reaction (e.g., fever, chills, rash, back pain, dyspnea).

How to Approach the Question

First, identify the key information in the clinical scenario: the patient is pregnant and has 'severe anemia' with a specific value of 'HB < 7 gm/dl'.
Recognize that a hemoglobin level below 7 g/dL is a critical value, indicating a life-threatening condition that requires immediate action.
Evaluate each option based on the urgency of the situation.
Consider the speed of action for each treatment: dietary changes and oral iron are slow, parenteral iron is faster but still takes time, while blood transfusion is immediate.
Eliminate options that are too slow to address an acute, severe condition (diet, oral iron, IM iron).
Select the intervention that provides the most rapid correction to prevent imminent complications, which is the packed cell transfusion.

Concept Tested & Keywords

Concept Tested: Management of severe anemia in pregnancy.
Stem keywords: pregnant woman, severe Anemia, HB< 7 gm/dl, treated by
Lead-in keywords: treated by
Clinical cues: Hb < 7 gm/dl indicates a severe, life-threatening level of anemia requiring urgent intervention.

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E6 Nutrition Monika Sharma 3e pp. 320-322, 319-321

E6 Parks TextBook of Preventive & Social Medicine part 2 — Subpart A (pp 1-232 of 464) p. 179-181