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Physiologic anemia of pregnancy — USMLE Step 3 MCQ

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EasyOB/GYN (prenatal care, contraception, screening)Physiologic anemia of pregnancyUSMLE Step 3

A 26-year-old pregnant woman at 24 weeks' gestation has fatigue. Hemoglobin is 10.9 g/dL, mean corpuscular volume is 88 fL, ferritin is normal, and reticulocyte count is normal. She has no bleeding. Fetal growth and vital signs are normal. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: E — Plasma volume expansion greater than red cell mass expansion

Physiologic anemia of pregnancy is dilutional, caused by plasma volume expansion exceeding the increase in red blood cell mass.

Reference: ACOG anemia in pregnancy guidance