ANSC March 2023 Update: St George and Sutherland hospitals

St George/Sutherland:

COVID-19 Update

Partners and support persons are now allowed in the St George and Sutherland antenatal clinics. Partners can also attend the Centring Groups.

Iron Infusion in Pregnancy

All women are offered screening for Iron Deficiency Anaemia in pregnancy by performing a Full Blood Count (FBC) at booking and 28 weeks gestation. A diet rich in iron and vitamin C is encouraged in conjunction with iron supplementation.

Consideration needs to be given to women with a history of haemoglobinopathies such as Sickle Cell and Thalassaemia where Iron Infusion is not the course of management.

Refer to Table: Management of Anaemia in Pregnancy

Iron Infusion

There is no strong evidence that first line therapy with intravenous iron is superior to oral administration for treating Iron Deficiency Anaemia in pregnant women, therefore its use should be limited.

Indications

• Iron Deficiency Anaemia (Hb,90g/dL) unresponsive to oral iron supplements.
• Pre-operative or pre-birth for women who are at risk of anaemia and unwilling to accept red cell transfusion.
• Post-partum haemorrhage with Hb <90g/L and not significantly symptomatic.

Contraindications for use

• Known hypersensitivity or allergy to Iron Polymaltose or Ferric Carboxymaltose.
• First trimester of pregnancy
• Iron overload (haemachromatosis)
• Anaemia not due to iron deficiency
• Acute renal infection
• Infectious hepatitis
• Hypophosphatasemia

How to organise an Iron infusion at St George Hospital

Iron infusions can be offered in the second or third trimester of pregnancy when the woman has Iron Deficiency Anaemia.

1. Give the woman a prescription for Ferinject with instructions to get the prescription filled and bring the Ferinject with her to ACU.
2. Complete the Ambulatory Care Unit (ACU) referral form including the pre pregnant weight and reason for referral.
3. Call ACU on 91133159 to make an appointment.
4. Fax referral form to ACU Fax No 31923
5. Give the woman the ACU referral form to bring with her to appointment.
6. Instruct the woman to present to Pregnancy Assessment Unit immediately after the infusion for a Fetal Heart Rate Assessment.