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An audit of screening for anaemia and the characterising of red cell indices and ferritin in pregnancy in one hospital
  1. P S Yeh1,2,
  2. L MacKillop1,
  3. D Harrington1
  1. 1Silver Star Unit, Maternal Fetal Medicine Department, John Radcliffe Hospital, Oxford, UK
  2. 2Peterborough Maternity Unit, Peterborough, UK

Abstract

Introduction As recommended by the National Collaborating Centre for Women's and Children's Health, our protocol screens for anaemia in pregnancy at booking and at 30 weeks. Iron supplementation is offered if Hb ≤11 g/100 ml or mean cell volume (MCV) <82 fl. If Hb ≥11 g/100 ml, ferritin is measured and iron supplementation is offered if ferritin ≤ 30 mcg/l.

Aims The aims were to establish adherence to national guideline and the characteristics of the red cell indices and ferritin as gestation advances.

Methods The first 50 consecutive women delivered from the January 1 2009 were selected. Information was obtained from hospital notes and laboratory records.

Results From the 50 women, 168 FBC samples were taken. The mean Hb, MCV and haematocrit (HCT) were 11.9 g/100 ml±0.9 (range 9.2–13.8); 88.0 fl±4.6 (range 72.1–97.2); and 0.35±0.03 (range 0.28–0.40) respectively. Both booking and 30 week FBC were done in 40 (92%) cases; 3 (6%) at 30 week (due to transfer of care from other units) and 1 (2%) at booking. 27 (54%) of the 50 women had MCV<82 or Hb ≤11 at any time. 18 (67%) has documentation of prescribed iron. Where Hb>11.0, ferritin was measured in 16 (32%) of cases and 82% had ferritin ≤30 mcg/dl.

Conclusion Adherence to guideline is good (98%) for blood sampling but less good (67%) in the prescription of iron. Where Hb ≥11 g/100 ml, majority (82%) had ferritin ≤30 mcg/dl. Hb and HCT tend to fall in second trimester and rises again in the third trimester. MCV tends to rise slightly and steadily throughout gestation.

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