The Blood Service, in partnership with three health services, has developed a new resource: the Toolkit for Maternity Blood Management: Improving identification and management of iron deficiency anaemia (the toolkit).
The toolkit aims to improve the detection and management of iron deficiency and anaemia in pregnant women in order to improve haemoglobin levels prior to delivery.
Routine ferritin screening is not currently recommended in obstetrics guidelines. If haemoglobin alone is measured, antenatal iron deficiency (ID) can go unnoticed. Increased iron demands during pregnancy may result in progression to iron deficiency anaemia (IDA). First trimester ID correlates with lower haemoglobin at delivery1, which increases risk for red cell transfusion in women with post-partum haemorrhage (PPH)2. Ferritin screening allows for detection of antenatal ID and allows early provision of iron therapy, resulting in improved haemoglobin levels prior to delivery.
Aimed at anyone involved in antenatal care, the toolkit assists in the identification and improved management of iron deficiency and anaemia. It includes:
- a haemoglobin assessment and optimisation action plan and flowcharts
- audits of antenatal iron deficiency, and
- patient handouts.
The toolkit includes implementation considerations for change management and allows for local customisation.
- Crispin P, Sethna F, Stephens B. Screening for iron deficiency in pregnancy with serum ferritin: A patient blood management strategy. HAA Annual Scientific Meeting 2017, 1 November 2017.
- Stephens B, Sethna F, Crispin P. Postpartum obstetric red cell transfusion practice: A retrospective study in a tertiary obstetric centre. Aust N Z J Obstet Gynaecol. 2018;58: 170-177. doi:10.1111/ajo.12680