Management of Anemia in Pregnancy-Cutting the Gordian Knot!

Objectives: To assess the efficacy and patient acceptability of different treatment modalities for antenatal management of anemia and the relative effects on length of stay. Method: A retrospective audit over six months from July 2019-December 2019 (n:70) in the Obstetric unit at King Abdul Aziz Hospital evaluating the anemia status of women in pregnancy and the management options offered were reviewed through their electronic medical records. Booking status, parity, age of gestation at diagnosis of anemia, clinical setup, and any coexistent conditions (chronic anemia, hemoglobinopathies) were evaluated against the treatment modalities offered: Oral iron, parenteral multiple doses regime, Single-dose ferric carboxymaltose, and blood transfusion. Results: Single-dose Iron regimens (Ferinject) as offered to 49 women had the least use of the length of stay, at a maximum of 2 days if administered along with Vitamin B12 injections (n:37) followed by 1 day (n:18) when given as sole treatment. This was followed by Blood transfusion (n:6) with periods varying from 3-11 days, and lastly multiple-dose Iron regimens (n:6) and the average length of stay being 4 days. Social acceptability and compliance to treatment were higher with the Ferinject group than others, with once-weekly dosing. In the whole cohort, only one patient developed mild rashes with Ferinject infusion and responded to targeted treatment. Conclusion: Effective use of resources and patient compliance is better achieved with single-dose modern regimens of Iron for correction of anemia rather than conventional methods. Careful patient selection and providing layman patient leaflets have improved impacts on outcomes of management