Obstetrics and Maternity Patient Blood Management

How do you manage your obstetric and maternity patients with anaemia? Here are some scenarios to consider.

Nancy Chan, age 32 is 4 months pregnant. She had a history of iron deficiency anaemia in her last pregnancy. Her Hb is 123 g/L and her ferritin is <5 µg/L.

What treatment, if any would you recommend?

Sally Johnson, age 29, is in her third trimester of pregnancy. She has iron deficiency anaemia. She was not able to tolerate the oral iron you prescribed, despite decreasing the dose and frequency, so stopped taking it. Her Hb has dropped further and she is scheduled for a LUSC in two weeks due to placenta praevia.

Do you prescribe more steak dinners?

Tell her to persist with oral iron?

Give her a shot of intramuscular iron?

Or schedule some intravenous iron ASAP?

Kaylee Jones, age 31, is 7 months pregnant with her third child. She is feeling short of breath walking down the street. Her haemoglobin is 61 g/L. She is pale and tachycardic.

Do you transfuse her? How many units?

Find out the answers and learn more in our latest Transfusion Q&A topic Obstetrics and Maternity Patient Blood Management Guidelines part 1: Anaemia

All cases are based on the National Blood Authority Patient Blood Management Guidelines and the explanations provide links to the guidelines and other resources.

Dr Sandy Minck, the author of this post, is a Medical Officer at the Australian Red Cross Blood Service and a member of the Transfusion Practice and Education team.