A 32-year-old woman, gravida 2 para 1, at 30 weeks gestation comes to the office for a routine prenatal visit. The patient's pregnancy has been uncomplicated, and she has had no vaginal bleeding or contractions. She has continued to jog daily throughout the pregnancy but is becoming more fatigued by the end of her workouts. The patient has no chronic medical conditions, and her only medication is a daily prenatal vitamin. She does not use tobacco, alcohol, or illicit drugs. Blood pressure is 110/70 mm Hg, pulse is 76/min, and respirations are 20/min. Fetal heart tones are normal. Physical examination is unremarkable. Compared to a nonpregnant state, this patient most likely has which of the following hematologic changes?

Question

A 32-year-old woman, gravida 2 para 1, at 30 weeks gestation comes to the office for a routine prenatal visit.  The patient's pregnancy has been uncomplicated, and she has had no vaginal bleeding or contractions.  She has continued to jog daily throughout the pregnancy but is becoming more fatigued by the end of her workouts.  The patient has no chronic medical conditions, and her only medication is a daily prenatal vitamin.  She does not use tobacco, alcohol, or illicit drugs.  Blood pressure is 110/70 mm Hg, pulse is 76/min, and respirations are 20/min.  Fetal heart tones are normal.  Physical examination is unremarkable.  Compared to a nonpregnant state, this patient most likely has which of the following hematologic changes?

Quizplus · Accepted Answer

Eductional Objective: Pregnant patients have marked increases in blood plasma volume (by 30%-50%) and red blood cell mass (by 20%-30%), which helps improve fetal nutrient delivery while also protecting against excessive blood loss during delivery.  Because the expansion of blood plasma volume is greater than the increase in red blood cell mass, pregnant women typically have mildly decreased hemoglobin concentrations (ie, dilutional anemia).

A 32-Year-Old Woman, Gravida 2 Para 1, at 30 Weeks