Management of Iron Deficiency Anaemia in Pregnancy

Abstract

Iron deficiency is the most common cause of anaemia during pregnancy. For prevention of anaemia, dietary modifications, deworming, food fortification and most importantly iron and folic acid prophylaxis in the second half of pregnancy for a period of hundred days is recommended. Oral iron therapy is a mainstay approach in treating iron deficiency anaemia. Conventional oral iron supplements, primarily ferrous salts, contain varying amounts of elemental iron but often suffer from low bioavailability and poor patient tolerance due to gastrointestinal side effects. This can lead to reduced compliance with treatment and diminished overall benefits. Newer iron preparations like liposomal iron have lesser gastrointestinal side effects and are better tolerated.

Ministry of Health, Government of India recommends 120 mg of elemental iron per day for mild anaemia, and 160 mg elemental iron per day for moderate and severe anaemia. Parenteral iron (commonly iron sucrose and ferric carboxymaltose) is used in cases of poor tolerance, non-compliance, poor absorption of oral iron and in those with moderate or severe anaemia in third trimester or near term. Blood transfusion is rarely indicated if there is decompensated anaemia (Hb <4g/ dL) anytime in pregnancy or severe anaemia near term or moderate anaemia, with cardiac failure, pre-existing heart disease or infections.