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Re-audit of management of anaemia in pregnancy
  1. H Y Wan Hussein,
  2. P K Sarkar
  1. Burnley General Hospital, East Lancashire NHS Hospitals Trust, Burnley, UK

Abstract

Background Maternal anaemia is still a cause of considerable perinatal mortality and morbidity. Prevalence worldwide varies between 23% and 52%. Screening and treatment for anaemia is recommended during pregnancy. A pilot audit was done in 2005.

Standards National Institute of Clinical Excellence guideline on Antenatal Care frecommends routine haemoglobin (Hb) screening at 12 and 28 weeks gestation. If anaemic or at increased risk; ferritin, folate, Vitamin B12 and electrophoresis should also be undertaken.

Population All women (n=65) delivered between August and October 2009 who had anaemia detected antenatally.

Method Retrospective case note analysis.

Results Prevalence was 10%. Demographics reflected our general population. Routine booking Hb were done >12/40 in 74%. Of these, 74% were anaemic. Only 48% had a further Hb screen at 28/40. Of those, 77% were anaemic. By term, 23% remained anaemic. Treatments were received in 94%.

Conclusions/discussions The prevalence of 10% justifies continued screening within our population. A large number were anaemic early in the pregnancy and remained so at 28 weeks. Lack of documentation regarding treatment times and follow-up made it difficult to assess treatment success. There is suggestion that delays in treatment were common after booking screening when compared to after 28 weeks. Treatment was successful in 55% overall with 23% still anaemic at term. The latter suggests that anaemia was treated more aggressively between 28 weeks and term. An information card with tables for dates of blood results and treatments similar to those on anticoagulation is suggested.

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