Red Blood Cell Indices and Morphology in the 3rd Trimester of Pregnant Women Attending Isra University Hospital

Abstract

Objective: To calculate RBC indices in third trimester of pregnancy among anemic and non-anemic women and to observe RBC morphology on peripheral blood smear.

Methodology: A cross-sectional comparative analysis was done at department of Obstetrics and Gynecology, Isra University Hospital Hyderabad, Sindh, from March 2019 to August 2019. All the gravid women aged 25 to 50 years old with 3rd trimester of gestation (more than 28 weeks of gestation) were included. Approximately 5 mL of blood was drawn into EDTA tubes. RBC indices, including hemoglobin concentration (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC), were measured using an automated hematology analyzer. Peripheral blood smears were prepared from the collected blood samples and stained. The stained smears were examined under a light microscope by a qualified hematologist and the morphology of RBCs were assessed. Analysis of data was done using SPSS version 26.0. 

Results: Study compared the red blood cell indices and morphology in the 3rd trimester of pregnant anemic and non-anemic women within a sample of 100 participants. Group A (non-anemic) had significantly higher mean Hb levels (11.6 ± 2.1 g/dL) compared to Group B (anemic) (7.7 ± 1.8 g/dL), with a p-value of 0.001. Mean hematocrit was significantly higher in Group A (36.8 ± 9.1%) than in Group B (30.3 ± 9.6%), and the mean RBC count (millions/µL) was also higher in Group A (3.49 ± 0.04) compared to Group B (2.82 ± 0.47), both with a p-value of 0.001. Further analysis showed that Group A had higher mean values for MCV (83.11 ± 11.26 fL vs. 64.56 ± 7.55 fL), mean MCH (28.28 ± 4.54 pg vs. 22.73 ± 4.28 pg), and mean MCHC (30.57 ± 4.33% vs. 23.32 ± 4.53%) compared to Group B, (p-0.0001) for all comparisons. Conversely, mean RDW was higher in Group B (15.13 ± 2.9%) than in Group A (11.20 ± 2.5%), (p-0.001).

Conclusion: The study revealed a high prevalence of anemia (65%) in the third trimester of pregnancy, characterized by significant decreases in RBC indices such as MCV) and MCH. Additionally, elevated RDW levels, even with normal MCV, is an indicator of iron deficiency anemia, especially during pregnancy