Issue link: https://viewer.e-digitaledition.com/i/992813
CHALLENGE There is a high prevalence of iron deficiency anemia (IDA) in obstetric patients. Reports indicate that IDA occurs in approximately 15 to 25 percent of all pregnancies 1 . According to the American Pregnancy Association, anemia during pregnancy is especially concerning because it is associated with low birth weight, premature delivery and maternal mortality 1 . It is critical for practitioners to accurately screen and manage IDA in pregnant patients. PRACTICAL SOLUTION Expanded CBC parameters available on Sysmex analyzers can provide practitioners with lab data to better screen and manage anemia. The use of the expanded parameters in high-risk populations is extremely helpful because it can alert practitioners to the presence of IDA when traditional tests are inconclusive. The reticulocyte parameters include: + Absolute Reticulocyte Count (#) and Percentage (%): reflects the quantity of newly produced red blood cells (RBC), indicating whether the bone marrow is producing and/or responding to therapy + Immature Reticulocyte Fraction (IRF): measures rate of erythropoiesis within the last 24–48 hours, indicating whether the bone marrow is producing and/or responding to therapy + Reticulocyte Hemoglobin Equivalent (RET-He): measure of the hemoglobin content in the reticulocytes, reflecting avail- ability of iron in the bone marrow that can be incorporated into new RBCs. SUCCESS The option for quick and inexpensive tests that do not require an added blood draw is significant. The IWK Health Centre in Nova Scotia, Canada, found the expanded CBC parameters to be extremely valuable with their maternal/fetal patient population. The following case study demonstrates how the lab data provided clinically significant information which improved the care for the expectant mother.* Patient History/Presentation: Healthy female expecting twins presents to her physician for a routine evaluation during her third trimester of pregnancy. Patient reported feeling tired but otherwise had no complaints. The CBC results are within normal limits. E x p a n d e d C B C D a t a : T h e r e t i c u l o c y t e p a r a m - eters show what has occurred in the bone marrow within the last 24–48 hours, which provides a more sensitive assessment of the patient's condition. The high end of normal IRF and the elevated reticulocyte counts indicate hyperproliferation of the bone marrow in response to low iron stores. The extremely low RET-He shows SPECIAL CLINICAL SECTION: WOMEN'S HEALTH BY MAGGIE FISCHER, RN, MS Getting More Bang for Your CBC Buck: Screening for Iron Deficiency Anemia in Pregnancy 1 4