Q: I am 29 years old and 29 weeks pregnant with my first child. There are some strange problems in my blood test report. My haemoglobin has gone down from 12.3 (taken when my pregnancy was confirmed)to 11g/dl; PCV has gone down from 37% to 32.1%; total leucocyte count is 12.66 x 10^3/ul; neutrophils is 72.6%; lymphocytes, monocytes, eosinophils and basophils are within range; ESR is 68 mm/h; fasting blood sugar is 82 mg/dl; post prandial blood sugar is 94 mg/dl and serum uric acid is 2.5 mg/dl. I am very worried to see these imbalances. Is this an indicator of complications in the future? My father was diabetic and died from a heart attack; my uncle died from TB and mother is suffering from arthritis. Even I have stiffness in joints and back pain every morning when I get up. But my gynaecologist said these are symptoms of pregnancy, and result due to bad posture. Kindly advise.

A:Regarding the haemoglobin and PCV, these are still within normal range for pregnancy, but have fallen. One reason can be that the first test was done within the first 12 weeks and the second repeated later on. As pregnancy advances, the blood volume increases with the red blood cells not increasing as much as the plasma - so a fall is generally noted. However, your haemoglobin should not fall below 11 gm/dL, so take iron and folic acid supplements and get our haemoglobin and PCV checked again after one month. Also, get a reticulocyte count done now and again after 10 days of iron and folic acid to make sure it rises (indicating response to treatment). TLC and neutrophils are slightly high (cut-off differs in different labs): make sure you do not have urine infection - get a urine culture done. ESR is usually raised during pregnancy, but one has to make sure it is not due to some infection. Your blood sugars are normal; however, I would advise a 100 g oral GTT(glucose tolerance test) in your case, as your father had diabetes. If your mother has rheumatoid arthritis, better to get yourself checked by an orthopaedic consultant before assumng joint stiffness is due to pregnancy.