Pregnant and Low Hb

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Offline hellokelli

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Pregnant and Low Hb
« on: November 04, 2009, 11:59:52 PM »
I have thal minor and am currently 6 months pregnant.  I just returned from an overnight stay in the hospital for kidney stones (no fun).  Last night they took a cbc and my Hb was 8.0.  This morning they took another cbc and it was 7.5. 

I always hover around the 9's but have never been this low before.  The doctor that was on call today is not my usual OB, and she seemed rather not concerned with a 7.5.  She said lots of pregnant women get anemic and I probably need iron.  I tried to explain to her, but I felt like I would have made more headway explaining thal to the hospital wall...

So she ran a bunch of test that my real OB already ran.  Electrophoresis, iron studies, etc. In my last iron studies my iron was very high, so I do not suspect my problem is iron deficiency anemia.  She told me to wait until next week to talk to my real OB about what my options are.

I am feeling EXTREMELY weak and tired, more so than usual.  This could be because of the kidney stones, so I can't be certain it's the thal.  I asked if I could be referred to a hematologist, but she wouldn't.  At this point what do you think I should do?  Should I be asking for a transfusion?  Am I over-reacting about the 7.5? 

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Offline Andy Battaglia

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Re: Pregnant and Low Hb
« Reply #1 on: November 05, 2009, 02:28:15 AM »
Hi hellokelli,

Minors do often drop to the Hb 8 range during pregnancy and sometimes do require a transfusion or two during the pregnancy, and since the temporary OB won't do anything, is it possible to contact your regular OB and ask that a hematologist be consulted? The OB is not a hematologist and knows nothing about thal, and isn't willing to do anything other than wait, and 7.5 is pretty low and most women will be transfused once it drops below 8. It may be that it did drop from the kidney stones and may rebound, but again, the OB is not trained to in the matter, so a referral seems appropriate. Because the hemoglobin level is somewhat distorted during pregnancy because there is an increase in plasma volume, the Hb level cannot be considered totally accurate and will measure below what it actually is as relates to the amount of red blood cells, it is something of a gray area and a hematologist would be best to make that decision about transfusion, keeping into account that the typical method of raising Hb during pregnancy, iron supplements, will not help. Does your insurance provider require a referral before you see a hematologist?
Andy

All we are saying is give thals a chance.

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Offline hellokelli

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Re: Pregnant and Low Hb
« Reply #2 on: November 05, 2009, 03:02:29 PM »
Andy- Thanks for the response!  Yes, I have an HMO and must get a referral to see a specialist like a hematologist.  I am going to call my regular OB today and ask for a referral.  I think I just needed some reassurance that I wasn't crazy for wanting a hematologist.  Thank you!

 

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