Management#
Oral iron therapy#
- Ferrous sulfate 200mg BD/TDS
- Follow up CBC after 2-3 weeks
If improvement#
- Continue oral therapy until 3 months after Hb becomes normal
If no significant improvement or severe anemia or intolerance for oral iron#
- Check serum ferritin
- If ferritin >= 30 mcg/L → exclude hemoglobinopathies
- If ferritin < 30 mcg/L → parenteral iron therapy
Parenteral iron therapy#
- Ferric carboxymaltose
- Dose depends on the pre-pregnancy weight or weight at the booking visit
- Continue oral iron after 5 days (if tolerated)
- Follow up CBC after 2-3 weeks
- Another dose of parenteral iron, if needed
Indications of blood transfusion#
- Hb <= 6 mg/dl and gestational age > 36 weeks
- Hb between 6-8 mg/dl with any of the following conditions:
- Established or incipient heart failure
- Pre-existing heart disease
- Pneumonia or any other serious bacterial infection
- Malaria