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The three trimesters of pregnancy
include various changes in digestive 
system,  nutrition  and 
metabolism,  changes  in circulatory system, respiratory system,
integumentary system, changes in coagulation, and fibrinolysis which is been
explained in various studies. Nearly, all
organ systems undergo profound changes during normal pregnancy to meet the demands
of the fetoplacental unit. There are both subtle

 and substantial changes in
hematological parameters during pregnancy and the puerperium, orchestrated by
changes in the hormonal milieu. A thorough 
understanding  of  these 
is important to avoid both over- and under-diagnosing abnormalities.

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 During pregnancy, the total volume
of blood increases by about 1.5 L, mainly to supply the needs of the new
vascular bed. Nearly, 1 L of blood is contained within the uterus and maternal
blood spaces of the placenta. Almost 25–80% of plasma volume gets expanded
during mid-pregnancy. Red cell mass also gets increased by 10–20% with the net
result in fall of hemoglobin (Hb) concentration.1


Red blood cell (RBC) mass begins
to increase at 8–10 weeks of gestation and steadily increases by 20–30% (250–450
mL) above non-pregnant levels by the end of pregnancy in thosewomen who were receiving iron
supplements.2,3 Among women who were
not on iron supplements, the red cell mass may increase only by 15–20%.4 Erythrocyte life span is slightly decreased
during normal pregnancy.5


There is increase in
erythropoietin level by 50% in normal pregnancies and vary according to the
presence of pregnancy complications.6 Increased plasma erythropoietin induces  the rise in red cell mass, which partially
supports the higher metabolic requirement for oxygen during pregnancy.7 Mean corpuscular volume decreases during
pregnancy and averages 80–84 fL in the third trimester
of pregnancy.8


White blood cell count (WBC) is increased in pregnancy with a typical reference range of 6 × 109–16 ×109/L.9 Within
few hours after delivery, healthy women have been documented to have WBC count
of 9 × 109–25 × 109/L.10 By 4-week postdelivery, typical WBC ranges are similar to those in
healthy non-pregnant women (4 × 109–10
× 109/L). There has been much
discussion about the normal ranges for the different types of white cells.11


The present study was done to evaluate the variations in RBC
and WBC counts before and after normal vaginal


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