This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
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? 
Select and explain. 
A. 9 mg %, B. 10 mg %, C. 11 mg %, D. 12 mg %
C: 11 mg %
Answer: C: 11 mg % 
Explanation: 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