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IV Iron in Pregnancy — RACP Adult Medicine MCQ

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ModerateHaematologyIV Iron in PregnancyRACP Adult Medicine

A 35-year-old pregnant woman at 28 weeks gestation has ferritin 12 μg/L and Hb 108 g/L. She has been non-adherent to oral iron due to GI side effects (constipation, nausea). She is symptomatic with fatigue. What is the most appropriate management?

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Correct answer: C — IV iron infusion

Pregnant women with iron deficiency (ferritin <30) and oral iron intolerance in the second/third trimester should receive IV iron infusion. IV iron (ferric carboxymaltose or iron polymaltose) is safe from the second trimester onwards and rapidly replenishes iron stores. Untreated iron deficiency in pregnancy increases risk of preterm delivery, low birth weight, and postpartum depression. Avoid IV iron in the first trimester (limited safety data).

Reference: RANZCOG – 2024 – Iron Deficiency in Pregnancy; NBA 2024