Anaemia in pregnancy

Question 1

When are women screened for anaemia routinely?

Answer 1

Booking
28 weeks

Women are offered haemoglobinopathy screening at the booking clinic for thalassaemia (all women) and sickle cell disease (women at higher risk). Both are causes of significant anaemia in pregnancy.

Question 2

Symptoms of anaemia

Answer 2

SOB
Fatigue
Dizziness
Pallor

Question 3

Low MCV

Answer 3

May indicate iron deficiency

Question 4

High MCV

Answer 4

May indicate B12 or folate deficiency

Question 5

Management of anaemia

Answer 5

Iron deficiency - iron replacement

B12 deficiency - should be tested for pernicious anaemia (checking for intrinsic factor antibodies). - IM hydroxocobalamin injections is an option

Folate deficiency - started on higher dose of 5mg folic acid

Thalassemia and Sickle cell - joint care with haematology - need high dose folic acid, close monitoring and transfusions as required