Regarding iron supplementation in pregnancy: a woman at 20 weeks has Hb 9.2 g/dL, MCV 68 fL, serum ferritin 8 ng/mL. She is on oral iron 200 mg/day elemental iron but compliance is poor due to GI side effects. The MOST appropriate alternative IV iron preparation with the best safety profile and ability to give as a single total-dose infusion is:

• A IV iron sucrose (Venofer)
• B IV ferric carboxymaltose (Ferinject) ✓
• C IV iron dextran (high-molecular-weight)
• D IV iron gluconate

Explanation

Ferric carboxymaltose (FCM) can be administered as a single dose up to 1000 mg (15 mg/kg) over 15 minutes without a test dose, making it highly convenient for total-dose replacement in pregnancy. It has an excellent safety profile with low rates of serious adverse reactions. High-molecular-weight iron dextran has the highest anaphylaxis risk and requires a test dose. Iron sucrose and gluconate require multiple smaller doses (maximum 200–300 mg per infusion). FCM is now preferred in guidelines for IV iron in pregnancy.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.