A 27-year-old primigravida attends the GP at 36 weeks of gestation. Her routine blood results show a haemoglobin of 94 g/L. She has been taking oral f...

Question

A 27-year-old primigravida attends the GP at 36 weeks of gestation. Her routine blood results show a haemoglobin of 94 g/L. She has been taking oral ferrous sulphate 200 mg twice daily since 28 weeks but reports nausea and constipation limiting adherence. Her ferritin remains low at 6 µg/L. Which is the single most appropriate next step?

Accepted Answer

Refer for intravenous iron infusion

Answer

Increase oral iron to three times daily

Answer

Switch to an oral iron preparation with lower elemental iron content

Answer

Transfuse two units of packed red cells

Answer

Reassure and continue current dose with stool softeners

uk-drcog MCQ (SBA): Refractory Iron Deficiency Anaemia in Pregnancy