A pregnant woman has microcytic, hypochromic red cells and a serum ferritin of 8 ng/mL. Which single cause of anaemia is most likely?

Answer: D. Iron deficiency anaemia

Iron deficiency anaemia

Iron deficiency is the commonest cause of anaemia in pregnancy.

This case

• Microcytic, hypochromic red cells are typical of iron deficiency.
• A serum ferritin below 15 ng/mL is diagnostic of iron deficiency (here 8 ng/mL).

Contrast

• Folate/B12 deficiency: macrocytic (megaloblastic).
• Physiological/dilutional anaemia: normocytic normochromic.
• Mixed nutritional deficiency: dimorphic (microcytic + macrocytic).

Management

• Iron supplementation (with vitamin C to aid absorption); parenteral iron or transfusion in selected cases.

So iron deficiency is the most likely cause.