Antenatal - Anaemia in pregnancy

Question 1

when are women routinely screened for anaemia during pregnancy?

Answer 1

booking clinic

28 weeks

Question 2

sometimes women with anaemia are asymptomatic but how can they present?

Answer 2

SOB

fatigue

dizziness

pallor

Question 3

what are the normal haemoglobin levels during pregnancy?

Answer 3

Question 4

describe the relationship between MCV and the causes of anaemia

Answer 4

low MCV - iron deficieny

normal MCV - physiological anaemia (increased plasma volume of pregnancy)

raised MCV - B12 or folate deficiency

Question 5

what conditions are women offered screening for that can both cause anaemia in pregnancy?

Answer 5

thalassaemia and sickle cell disease

Question 6

what additional investigations that are not routinely performed can be done to further investigate the cause of anaemia?

Answer 6

Ferritin

B12

Folate

Question 7

how are women with anaemia in pregnancy treated?

Answer 7

iron replacement eg ferrous sulphate 200mg 3 times a day

Question 8

how are women with low ferritin but not anaemia treated

Answer 8

supplementary iron

Question 9

what should women with low B12 be tested for?

Answer 9

pernicious anaemia (checking for intrinsic factor antibodies)

Question 10

how should low B12 be managed in pregnancy?

Answer 10

• haematologist input
• intramuscular hydroxocobalamin injection
• oral cyanocobalamin tablets

Question 11

describe normal folate regime in pregnancy

Answer 11

all women take 400mcg folic acid per day

folate deficiency started on 5mg folic acid per day