A primigravida at 36 weeks is found to have haemoglobin of 8.2 g/dL with MCV 66 fL, serum ferritin 6 µg/L. She has been on oral iron for 8 weeks with poor compliance. What is the preferred treatment at this gestation?

• A Continue oral ferrous sulphate at higher dose for 4 more weeks
• B Blood transfusion immediately
• C IV iron sucrose infusion ✓
• D IM iron dextran injections

Explanation

At 36 weeks with moderate iron-deficiency anaemia (Hb 8.2 g/dL) and documented poor compliance with oral iron, parenteral iron (IV iron sucrose or ferric carboxymaltose) is indicated. IV iron raises haemoglobin faster than oral iron and is well tolerated. Blood transfusion is reserved for severe anaemia (Hb <7 g/dL) or haemodynamic compromise. IM iron dextran is less preferred due to pain, staining, and rare anaphylaxis. With delivery imminent at 36 weeks, IV iron achieves the most rapid and effective correction.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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