Anaemia In Pregnancy

Question 1

When are pregnant women routinely screened for anaemia

Answer 1

• Booking clinic

- 28 weeks gestation

Question 2

Presentation of anaemia in pregnancy

Answer 2

Mostly asymptomatic

Can have:

• SOB
• pallor
• fatigue
• dizziness

Question 3

Investigations for anaemia in pregnancy

Answer 3

• FBC
• B12 and folate
• Iron
• Haemoglobinopathy screening - rule out thalassaemia and sickle cell disease

Question 4

Causes of anaemia during pregnancy

Answer 4

Physiological due to increase in plasma

Iron deficiency

B12 or folate deficiency

Thalassaemia

Sickle cell disease

Question 5

Management of anaemia during pregnancy

Answer 5

Treat underlying cause

Question 6

Management of B12 and folate deficiency

Answer 6

Intramuscular hydroxocobalamin injections

Oral cyanocobalamin tablets

Women with folate deficiency are started on folic acid 5mg daily (higher dose)

Question 7

What test should be done for women with low B12

Answer 7

Tested for pernicious anaemia (checking for intrinsic factor antibodies)

Question 8

Pregnant ladies with thalassaemia and sickle cell anaemia

Answer 8

Haemoglobinopathy managed jointly with a specialist haematologist.

High dose folic acid (5mg)

Close monitoring and transfusions when required