Haemoglobin <110 g/L in the first trimester, <105 g/L in the second/third, or <100 g/L postpartum.
Investigations
- • FBC, ferritin (<30 μg/L confirms deficiency)
- • B12, folate, haemoglobinopathy screen
- • Reticulocytes and blood film if unclear
Management
- • Oral iron 100–200 mg elemental daily or alternate-day (better absorbed)
- • IV iron from second trimester if intolerant, non-responsive or late presentation
- • Transfuse only for Hb <70 g/L with symptoms or ongoing bleeding
- • Folic acid 5 mg if haemoglobinopathy or high risk
Clinical pearls
- • Alternate-day dosing raises absorption by lowering hepcidin
- • Correct anaemia before delivery to reduce PPH morbidity
Educational — verify locally.
