A 32 week pregnant primigravida presented with dyspnoea. Her hemoglobin is 10 mg%. What is the minimum hemoglobin levels in pregnancy below which anemia can be diagnosed?

According to the standard laid down by WHO, anaemia in pregnancy is present when the haemoglobin concentration in the peripheral blood is 11 gm/100 ml or less. During pregnancy plasma volume expands (maximum around 32 weeks) resulting in hemoglobin dilution. For this reason, haemoglobin level below 10gm/dl at any time during pregnancy is considered anemia (WHO - 1993, CDC 1990). Hb level at or below 9gm/dl requires detailed investigations and appropriate treatment. Ref: Text Book of Obstetrics by D.C.Dutta, 6th edition, Page 262