2.14.1. Antenatal infusion is based on consultant decision. Evidence of approval from consultant should be uploaded to the electronic record as an attachment.
2.14.2. A serum Ferritin <30 micrograms/l is confirmation of iron deficiency anaemia.
2.14.3. If in community, refer to maternity triage for infusion.
2.14.4. Administer according to prescription.
2.14.5. Postnatal infusions will take place either on delivery suite or Wheal Fortune, or if referred, in maternity triage.
2.14.6. Administer 1g IV iron (Ferinject) according to protocol (Appendix 3 and 4).
2.14.7. A test dose is NOT required for 1g iron preparations. Risk of anaphylaxis - 1 in 10,000 cases (0.01%).
2.14.8. Other uncommon side effects include fast pulse, low BP and feeling dizzy.
2.14.9. There is a small risk of semi-permanent discoloration to the patient's arm. This may be very slow to fade (years). Please warn the patient of this risk. Ask the patient to keep their arm straight during the infusion to reduce the chance of extravasation. Complete visual infusion phlebitis (VIP) score and remain with the patient following start of transfusion to observe closely for signs of extravasation (NEW 2025).
2.14.10. Oral iron should be avoided for 5 days after the administration of Ferinject as it is unlikely to be absorbed when circulating iron levels are high.
2.15.1. Make up single dose infusion 1000mg/1 vial of Ferinject diluted with 250ml 0.9% saline via infusion at 500ml/hr over 30 minutes.
2.15.2. Administer as per Appendix 3 and 4.
2.15.3. Re-check Hb 6 weeks after IV Iron dose and follow flowchart (New 2026).
2.15.4. If woman is still symptomatic, can recheck earlier. They can have a second dose at 14 days. Will need consultant input (New 2026).
2.15.5. Expected outcome = increase can Hb of as much as 20g/l in 5-7 days, 30-40g/l after 2 weeks. However, it is recommended to check at 6 weeks unless symptomatic.