ANAEMIA IN PREGNANCY

DESCRIPTION

Haemoglobin (Hb) <11 g/dL. Anaemia in pregnancy is mostly due to either iron deficiency, folic acid deficiency or a combination of both. Women with iron deficiency may have ‘pica’, e.g. eating substances such as soil, charcoal, ice, etc.

 

GENERAL MEASURES

A balanced diet to prevent nutritional deficiency.

 

MEDICINE TREATMENT

 

Prophylaxis

  • Ferrous sulphate compound BPC, oral, 170 mg daily with a meal.

PLUS

  • Folic acid, oral, 5 mg daily.
    • Continue with iron and folic acid supplementation during lactation.
    • Treat other causes of anaemia according to the diagnosis.

 

Folic acid deficiency

  • Folic acid, oral, 5 mg daily.

 

Identify and treat associated vitamin deficiencies accordingly.

 

Iron deficiency

  • Ferrous sulphate compound BPC, oral, 170 mg 8 hourly with meals.
    • Continue for 3–6 months after the Hb reaches normal to replenish iron stores.
    • Hb is expected to rise by at least 1.5 g/dL in two weeks.
    • If Hb does not increase after two weeks, do a full blood count (FBC) to confirm hypochromic microcytic anaemia.
    • When using iron together with calcium supplementation, ensure that iron and calcium are taken at least 4 hours apart from one another.

Parenteral iron

If there is no response to oral iron, review adherence and do a FBC. If iron deficiency is confirmed on FBC and oral iron is not tolerated consider intravenous iron sucrose using the following formula:

Total dose = weight (kg) x [11 g/dL – actual Hb (g/dL)] x 2.4 + 200 mg.

Maximum daily dose: 200 mg.

Administer over 30 minutes in 200 mL sodium chloride 0.9%. Repeat every second day until the total dose is given.

See also  Laboratory Sampling Techniques

 

If delivery is anticipated within 3–5 days, consider blood transfusion in women with a Hb <7 g/dL.

 

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