**The reference ranges for hematocrit and hemoglobin span both female and invalid”.5 The correlation coefficient, r, can be used as a guide to assess the. Considering the relationship of low and high levels of hemoglobin and changes in hemoglobin and hematocrit values during the second and first half of .. Numerical values were represented as mean (standard deviation);. Reference ranges reflect the numeric values found in healthy people; An increased RBC count and increased levels of hemoglobin and hematocrit may be .
In a prospective cohort study, Iranian pregnant women, aged 15 to 45 years that were supported by health centers in Isfahan, Iran, were recruited using quota sampling method. Exclusion criteria comprised of 36 conditions that were related to the maternal and infant outcomes. Hemoglobin and hematocrit were measured in eligible mothers during the 6thth weeks and 26thth weeks of pregnancy.
They were monitored until delivery and the data regarding their pregnancy outcome were collected. Hemoglobin levels in the first and second half of pregnancy can predict preeclampsia and premature preterm rupture of membranes. Increased hematocrit levels in the second half of pregnancy or lack of reduction of hematocrit levels in the second half compared to the first half can estimate preeclampsia. Maternal anemia has been considered as a risk factor for an undesirable pregnancy outcome. Normal level of hemoglobin is 12 to 16 grams per deciliter for women of childbearing age.
Its minimum normal value is 11 grams per deciliter in the first and third trimester of the pregnancy and Its amount gets lower than normal due to anemia and higher than normal because of erythrocytosis. Normal values of hematocrit have been determined from 36 to 48 percent for women in childbearing age. The cause of its decrease in adults and during pregnancy is anemia, and the reasons for its increase are myeloproliferative disorders, chronic obstructive pulmonary disease and other hypoxic lung conditions.
Both hemoglobin and hematocrit are measured through fresh whole blood and are dependent on plasma volume.
Thus, factors such as dehydration as well as overhydration can affect the test results.
Therefore, change in the mentioned parameters can be a warning of a high-risk pregnancy. We also aimed to study the changes in hemoglobin and hematocrit values during the second half of pregnancy compared to the first half and its relationship with pregnancy outcome.
Sampled population was Iranian women aged 49 years covered by health centers whose delivery in hospital led to the birth of alive and apparently healthy baby.
Subjects were selected from different centers through quota sampling method. Considering the possibility of loss to follow up and exclusion of the subjects whose babies suffered from abnormality, intrauterine fetal death and newborn death, a larger sample size about 50 was determined. Exclusion criteria 36 items were conditions and states that affect pregnancy outcome.
These condition included causes of preterm delivery, low birth weight, preeclampsia, premature rupture of membranes, preterm premature rupture of membranes, smoking, drug addiction, digestive disorders, hemoglobinopathies, nutritional diseases, allergies and mental disorders. To determine the mentioned criteria, the results of the routine tests during pregnancy as well as the result obtained by the medical examination of the physician and the recommendation of the specialist in necessary cases were used.
Pregnant women with gestational age of 6 weeks or less were interviewed in their first visit for prenatal care and in case they were eligible and willing to participate in the study, they were recruited. The participants were referred to the laboratory during the 6th- 11th and 26thth weeks of gestational age and their hemoglobin and hematocrit were measured.
It should be noted that 96 percent of the subjects took iron and folic acid pills. However, in order to increase the confidence in the study, all patients were referred to the same laboratory and all the samples were evaluated by the same technician. Further, the subjects were monitored until the delivery and the data regarding their pregnancy outcome were collected through birth files, prenatal care files and phone calls. Data collection tool was questionnaires which were completed through interviews with eligible mothers either in person or by phone call.
Content validity of the questionnaire was confirmed by experts. The data in the prenatal care and delivery files which had been completed by midwives, obstetricians, and neonatologists were used to determine the reliability of the questionnaire.
Numerical values were represented as mean standard deviation. Hemoglobin in the first half of pregnancy was Hemoglobin in the second half of pregnancy was Minimum and maximum amounts of hemoglobin were 7.
Moreover, the minimum and maximum values of hematocrit in the first half were calculatedas 26 and The average hemoglobin and hematocrit in two halves of pregnancy in women who were affected with premature rupture of membranes before the onset of labor and after 37 weeks were not different with other mothers. Furthermore, there was no statistically significant difference in the average hemoglobin and hematocrit in two halves of pregnancy between those who had vaginal delivery and cesarean section Table 1.
Table 1 Open in a separate window In the present study, about 2. About 4 percent of subjects had signs and symptoms of preeclampsia. To study the changes in hemoglobin and hematocrit values in the second half of pregnancy compared to the first half, the difference between hemoglobin and hematocrit in the two halves of pregnancy was determined for all of mothers.
In the next step, the relationship of the difference between hemoglobin and hematocrit in the two halves of pregnancy was assessed with premature rupture of membranes and preterm premature rupture of membranes, delivery type, preeclampsia, and gestational age.
They believed that low levels of hemoglobin may be a sign of a concealed infection. The proposed explanation for this relationship was the lower socioeconomic and nutritional condition in these mothers.
Through the study conducted on pregnant mothers, Karaflahin et al. Thus, it was stressed that family planning and pre-pregnancy assessments is needed to reduce the adverse effects.
In this study, it became clear that the significant inverse relationship between hematocrit in the second half and birth weight and height was overshadowed by gestational age and in fact gestational age is the most important variable associated with hematocrit values.
The significant inverse relationship between the hematocrits in the two halves of pregnancy and gestational age can be noted as one of the other results obtained in this study.
Accordingly, by increase in gestational age, hematocrit decreased and physiological dilution of blood became more visible. Prick the fingertip with the lancet. Place the hematocrit tube near the incision site and allow the blood to flow via capillary action into the hematocrit tube until it is two-thirds to three-fourths full or to a predesignated mark on the tube.
Avoid "milking" the finger if possible; this causes the expression of tissue fluids and may result in a falsely low hematocrit. Always fill at least three tubes. For hematocrits obtained by venipuncture, draw a sample of blood into the tube containing anticoagulant and mix well. Dip the hematocrit tube into the blood and allow the blood to rise to the desired two-thirds to three-quarters level.
Because blood cells naturally sediment, a prior thorough mixing of the blood in the tube is necessary to ensure accurate reading.
After cleaning the outside of the hematocrit tubes of excess blood, invert the tube slowly so that the blood migrates just short of the bottom end of the tube. Seal the bottom of the tube with sealant. Make certain that little or no air is interspersed in the column of blood.
If the seal is incomplete, leakage will occur during centrifugation and false readings will be obtained. Place the tubes in a microhematocrit centrifuge and spin for 3 to 5 minutes at high speed. A shorter spin will not allow for complete sedimentation. Using either a hematocrit reader or any ruled apparatus, measure the length of the column of the packed red cells and divide it by the length of the whole column of blood cells and plasmaas in Figure Average all readings obtained from the different microhematocrit tubes.
The hematocrit is a ratio of the packed cells to total volume. Hemoglobin Hemoglobin determinations will usually be performed by an automated cell counter from a tube of well-mixed EDTA-anticoagulated blood filled to a predetermined level.
In this assay, all forms of hemoglobins are converted to the colored protein cyanomethemoglobin and measured by a colorimeter. An inadequate sample, whether due to insufficient volume or inadequate anticoagulation, may give false readings.
If it is necessary to determine the level of anemia quickly, the hematocrit is an easier, more convenient test.
Hemoglobin and Hematocrit - Clinical Methods - NCBI Bookshelf
Hemoglobin Electrophoresis Hemoglobin electrophoresis measures the mobility of hemoglobin in an electric field; it can therefore detect only those abnormalities in hemoglobin that alter the charge.
Electrophoretic mobilities are affected by pH and by the medium in which the test is conducted. Screening tests typically use a hemolysate of anticoagulated blood electrophoresed on cellulose acetate at pH 8. If necessary, a further electrophoresis in starch gel at pH 6.
At that stage, the work will usually be performed by a specialized laboratory. Hemoglobin electrophoresis will not readily assess situations where there are neutral amino acid substitutions or where the hemoglobin is normal but the constituent chains are not produced in equal numbers thalassemias. The diagnosis of alpha thalassemia of a mild to moderate degree cannot be made by hemoglobin electrophoresis; the diagnosis of beta thalassemia may be made by inference from an increase in the Hb A2.