Blood Conservation- An Innovative Program for the Treatment of Prenatal Anemia
- Identify the causes of anemia in pregnancy.
- Identify the risk associated with prenatal anemia.
- Formulate a treatment plan specific to the iron deficient prenatal
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Implementation, outcomes and evaluation:
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Blood Conservation- An Innovative Program for the Treatment of Prenatal Anemia
Abstract
As many as one third of pregnant patients suffer from anemia. Iron deficiency is responsible for ninety five percent (95 %) of anemia in pregnancy.
The purpose of this presentation is to demonstrate how the blood Conservation Program limits the patient’s exposure to blood products by aggressively treating iron deficiency with the goal of raising hemoglobin and hematocrit to a safe level before delivery.
Prenatal patients have a complete blood count checked at twenty eight weeks. If the patient is diagnosed with anemia a consult to the Blood Conservation Program is initiated. An anemia diagnosis is made by hemoglobin less than 10 g/dl and hematocrit less than thirty percent (30%). To confirm iron deficiency a low ferritin, low serum iron, and high iron binding capacity is seen.
A program is outlined to assess for iron deficiency and implement a treatment plan.
The initial treatment offered by the Blood Conservation Program is to provide instructions on the best way to take oral iron to increase absorption. Patients are asked to add ferrous sulfate 325 mg and vitamin c 250 mg once a day to already prescribed daily prenatal vitamins.
Through collaboration with the patient’s provider the patient is aggressively treated. Patients with a ferritin of less than 50 ng/ml are given intravenous iron sucrose in divided doses over three weeks. They continue to take oral iron, vitamin c, and prenatal vitamins. A repeat check of blood count and iron levels are done two to four weeks after the last iron infusion and treatment is repeated as needed.
Results have yielded significant increases in hemoglobin and hematocrit levels in a six to ten week period. In case studies patients have indicated increased quality of their pregnancies as described by having more energy, feeling overall better, have the ability to care for other children at home and participate in activities of daily living.
