Oral Presentation Society of Obstetric Medicine of Australia and New Zealand ASM 2015

Anaemia in Pregnancy: More or Less Iron? (#14)

Lachlan Hayes 1
  1. Austin Hospital, Heidelberg, VIC, Australia

The majority of anaemia encountered in pregnancy is either physiological or due to iron deficiency. Other causes of anaemia, while rare can be troublesome if not considered during the initial workup phase or in women failing to respond to iron supplementation. The exact incidence of anaemia and the underlying cause varies depending on the sociodemographic, cultural and specific circumstances of the individual pregnant woman and the degree of their interaction with the health system. Multiple contributing factors in the prepartum, late pregnancy and postpartum periods contribute to a pregnant woman’s vulnerability to anaemia. The exact effect of anaemia on the health of the mother and foetus is difficult to quantify but more recent evidence suggests a significant deleterious effect across a range of maternal and metal outcomes that is possibly preventable.

Guidelines and policies dealing with the prevention, detection and management of anaemia in pregnancy are predominantly expert opinion based or sponsored by pharmaceutical manufactures and evidence to guide clinical practice is unfortunately thin. Until recently, engagement from obstetricians, midwives, anaesthetists, obstetric physicians and haematologists has been variable and often limited. Newer approaches to patient blood management (PBM) triggered by the increasing recognition of the financial cost of blood as opposed to the previous focus on safety of blood have led to increased interest in exploring the role of newer formulations of intravenous iron as an alternative therapy or even as a preventative measure in the setting of pregnancy associated anaemia. 

An illustrative case will be presented to challenge the audience and questions at the end are encouraged.