How to Treat Anaemia In Pregnancy?

Things to note:

• A balanced diet to prevent nutritional deficiency.

Medical 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.

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

When to refer:

• No response to management.