Diagnosis and treatment of iron-deficiency anaemia in pregnancy and postpartum
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Iron deficiency occurs frequently in pregnancy and can be diagnosed by serum ferritin-level measurement (threshold value < 30 μg/L). Screening for iron-deficiency anemia is recommended in every pregnant women, and should be done by serum ferritin-level screening in the first trimester and regular hemoglobin checks at least once per trimester. In the case of iron deficiency with or without anaemia in pregnancy, oral iron therapy should be given as first-line treatment. In the case of severe iron-deficiency anemia, intolerance of oral iron, lack of response to oral iron, or in the case of a clinical need for rapid and efficient treatment of anaemia (e.g., advanced pregnancy), intravenous iron therapy should be administered. In the postpartum period, oral iron therapy should be administered for mild iron-deficiency anemia (haemorrhagic anemia), and intravenous iron therapy for moderately severe-to-severe anemia (Hb < 95 g/L). If there is an indication for intravenous iron therapy in pregnancy or postpartum, iron-containing drugs which have been studied in well-controlled clinical trials in pregnancy and postpartum such as ferric carboxymaltose must be preferred for safety reasons. While anaphylactic reactions are extremely are with non-dextrane products, close surveillance during administration is recommended for all intravenous iron products.
KeywordsIron deficiency Anemia Pregnancy Postpartum Intravenous
Compliance with ethical standards
This study was funded by the Swiss Society of Gynecology and Obstetrics (SSGO).
Conflict of interest
C. Breymann has received speaker and workshop honorarium, and clinical study support from Vifor Inc. C. Honegger declares that he has no conflict of interest. I. Hösli has received speaker honorarium from Vifor Inc. D. Surbek has received speaker honorarium and an unrestricted grant for a investigator-initiated study from Vifor Inc.
This article does not contain any studies with human participants or animals performed by any of the authors.
This expert recommendation has been reviewed by the members of the Quality assurance committee of the SSGO. The Quality Assurance Committee of gynécologie suisse/SGGO (Swiss Society of Obstetrics and Gynaecology) compiles guidelines and expert letters with utmost care. However, the Quality Assurance Committee of gynécologie suisse/SGGG accepts no responsibility for the correctness and completeness of the content. The manufacturer’s instructions must be observed at all times, in particular the dosage instructions. To the Committee’s best knowledge, guidelines and expert letters correspond to the latest scientific insights at the time of publication. Users must take intervening changes into account.
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