Recommendations

• IV iron therapy should be considered from the 2nd trimester onwards in pregnant women with iron deficiency anemia that cannot tolerate or do not respond to oral iron therapy.

• With severe anemia (Hb ≤9 g/dL), the presence of risk factors (such as coagulation disorders, placenta previa) and conditions that require prompt resolution of anemia (paleness, tachycardia, tachypnea, syncope, heart failure, respiratory failure, angina pectoris, and signs of cerebral hypoxia) are other potential indications for IV iron therapy.

• The IV iron therapy dose should be individual patient based and bringing the Hb level up to at least 11 g/dL should be the target of the therapy.

• Switching from oral to IV iron therapy or starting IV therapy initially is contingent upon risk-benefit assessment; however, such assessment should be performed on an individual patient basis and requirements should be evaluated carefully.