Question

what is the significance of these abnormal values and what are the norms for pregnant women ( please type and be specific i don't want an article from google thanks :)

Postpartum

WBC 11.6 (H)

RBC 3.80 (L)

HGB 9.3 (L)

MCV 77.2 (L)

MCH 24.6 (L)

MCH 24.6 (L)

RDW 27.7 (H)

Chemistry: Sodium 135 (L)

Creatinine 0.54 (L)

AST 12 (L)

Alkaline Phosphate 113 (H)

Answer 1

Significance of blood values during pregnancy and postpartum:

White Blood Cells:

The normal WBC value in the 3.5 to 9.1 X 10⁹ /L. Usually, the WBC increases during labor and returns to normal after one week of postpartum. If still, WBC persists high, it shows the signs of infection.

Red blood cells:

During pregnancy, the red blood cell count increased above 1.5 litres in order to compensate for the blood loss during delivery and postpartum period. So during the first trimester, RBC reaches up to 4.55 X 10¹²/L The plasma volume increased by 15%. Iron deficiency, excessive blood loss during delivery and postpartum results in low RBC level.

HGB :

Hemoglobin increases throughout pregnancy. In the first-trimester hemoglobin can varies from 11.6 to 13.9g/dL. It can reach up to the value of 15g/dL. Iron and folic supplements can increase the value of Hb level. It takes about 4 to 6 months postpartum to reach the normal values of 12 to 15.8g/dL. Low Hb indicates the postpartum anemia due to lack of iron and ferritin.

MCV :

There is a slight increase in the Mean corpuscular volume during the entire pregnancy. It ranges from 82.4 to 100.4 in the third trimester. If there is a decreased red cell count, MCV also decreases. Iron deficiency anemia results in low MCV value whereas pernicious anemia result in high MCV value.

MCH:

MCH can range from 27 to 32 in the normal adult. It increases little during the second trimester to 33pg/cell and reaches the normal value in the third trimester. When the red blood cells cannot able to carry hemoglobin and deficiency of iron results in Low MCH values.

Red cell Distribution Width:

RDW mildly elevated during the second trimester and reach the normal value in the third trimester. RDW is associated with thyroid status. In the case of subclinical hypothyroidism, there will be low RDW level.

Sodium:

During pregnancy, the sodium increases in the first 17 weeks of pregnancy, and during the postpartum. In the case of hypertension, increased sensitivity to Angiotensin II, salt-restricted diet all results in low sodium levels.

Creatinine:

Usually, the creatinine increased during the pregnancy and returns to the normal level of 25 to 36umol/L during the postpartum. Low muscle mass, liver disease, and diet-related with low creatinine level.  

Aspartate aminotransferase:

The AST level during postpartum is 12 to 38U/L. Uremia, deficiency of vitamin B6, may decrease the level of AST level.

Alkaline Phosphate:

The reference value of Alkaline phosphate level is 33 to 96U/L. It reaches the peak level of up to 229 in the third trimester. Elevated AKT is due to some of the causes such as cholestasis of pregnancy, biliary obstruction.