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Re: anemia in pregnancy From: Steve Raymond (eryl@intekom.co.za) Sat May 24 14:30:26 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: kate dorly: "anonymous pain" Previous message: Florine Everett: "I've been searching long" Maybe in reply to: Charlie Chambers: "anemia in pregnancy" This is what the Cochrane reviewer says; Main Results Twenty trials were included. Iron supplementation raised or maintained the serum ferritin above 10 milligrams per litre. It resulted in a substantial reduction of women with a haemoglobin level below 10 or 10.5 grams in late pregnancy. Iron supplementation, however, had no detectable effect on any substantive measures of either maternal or fetal outcome. One trial, with the largest number of participants of selective versus routine supplementation, showed an increased likelihood of caesarean section and post-partum blood transfusion, but a lower perinatal mortality rate (up to 7 days after birth). Reviewers' conclusions Iron supplementation appears to prevent low haemoglobin at birth or at six weeks post-partum. There is very little information on pregnancy outcomes for either mother or baby. There are few data derived from communities where iron deficiency is common and anaemia is a serious health problem. What we do is give iron and folate to all pregnant women in the clinics, but double the Fe dose for those with low Haemoglobin, defined as Hb less than 10, who also get investigated for parasites. Darin INgels, ND wrote: >At Tue, 13 May 2003, Charlie Chambers wrote: > >>We're having a debate among providers and thought I'd seek other's >>input regarding anemia. At what Hgb or Hct, do others treat anemia in >>pregnancy with iron? How much do others use? Is there any evidence to >>suggest that aggressive treatment affects fetal outcome? >> >>The majority of our opinions have been to treat for less than 32%, >>though others feel this is too aggressive. To give one iron tab q day, >>and no there doesn't seem to be much evidence to support this strategy. >>************************************************************************ >>**** >>********************************************************************** >> >>Charlie Chambers >>***** >>************************************************************************ >>Several studies show that women can be iron deficient long before Hgb and Hct drop, so we monitor ferritin to determine whether a woman is a good candidate for iron therapy. Studies suggest ferritin less than 50 constitutes administering iron. We have treated hundreds of women with low ferritin with iron without any adverse side efects. We recheck their ferritin after 2 months to make sure they are absorbing and utilizing iron appropriately. >> >> -- S.H. Raymond FRCOG Principal Specialist Department of Obstetrics & Gynaecology Empangeni Hospital Private Bag X20005 Empangeni SOUTH AFRICA 3880 Phone: (+27)-35-9028560 Fax: (+27)-35-7922596 Next message: kate dorly: "anonymous pain" Previous message: Florine Everett: "I've been searching long" Maybe in reply to: Charlie Chambers: "anemia in pregnancy"

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