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81
Investigation of Anaemia at the Ante natal Clinic
Church Road Highgate
About 140 new cases are registered every year at this clinic
they are drawn from a wide cross section of the population and the
five social classes of the Registrar General are represented more
or less equally. They also include women of many nationalities
i.e. Irish, Jamaican, African, Swedish German French Italian.
Greek, Polish and American.
A medical officer of the Department Dr. H. Gunn, reports
that the estimation of haemoglobin levels in expectant mothers has
been carried out at this clinic since 1953. For the first few
months the Tallquist Haemoglobin Scale was used but this was later
abandoned for the Sahli Haemoglobinometer which was found to be
more accurate and easier to read in artificial light.
At their first visit to the ante-natal clinic, all patients
who are to be confined at home or in the Alexandra Maternity Home
have samples of blood taken for determination of Blood Group,
Rh Factor and Haemoglobin. Approximately 86% of these women make
their first visit at or before the 18th week of pregnancy. Of
the remaining 14% the majority are seen before the 18th week but
there are a few who make their first visit much later either because
they have recently moved into the district or because they have
neglected to make any arrangements for their confinement or antenatal
care. In almost all of these cases the Hb has not been
determined previously and their figures are included with the
"first visit" estimations given below.
Although some authorities are concerned that the so-called
"physiological anaemia of pregnancy" is a true hypochromic anaemia
and that the Hb s of pregnant women can be maintained at or above
90%, with adequate iron therapy, 80% has been taken as the dividing
line in this clinic.
To all women with Hb levels below 80% is given a month s
supply of Fersolate Tablets (l T. D S ) and they are asked to collect
further supplies at each visit until they are told to discontinue.
If they report severe constipation abdominal pains or vomiting as
a result of taking the tablets an alternative iron preparation is
offered
A second Hb estimation is made at the 34th week and treatment
is stopp ed i f the Hb has reached 80%, It is not possible, however,
to follow up all the original cases as a number are lost owing to
miscarriage moving out of the district or transfer to hospital