Iron Infusion Service

The Iron Infusion Service supports the identification and treatment of iron deficiency in pregnancy.

​​Patient eligibility

Family physicians, nurse practitioners, midwives, and obstetricians may order a single outpatient IV iron dose for pregnant individuals registered to give birth at BC Women’s Hospital who meet all the following criteria (including patients with known thalassemia):

Lab criteria:

  • Hemoglobin (over the last 4 weeks): 95–105 
  • Ferritin (over the last 4 weeks): ≤ 30 
    • ​​Patients with known thalassemia: ≤ 50  

Patient criteria:

  • Current gestational age: 24+0 weeks to 34+6 weeks 
  • Oral iron trial: Completed 1 month with good adherence or did not tolerate

Oral iron trial  

To maximize absorption and effectiveness, patients should:
  • Take iron three times per week
  • Take iron with vitamin C
  • Take iron on an empty stomach, one hour before meals or two hours after meals
  • Avoid calcium interference by not taking calcium supplements or multivitamins containing calcium within two hours of taking iron medication
If iron is not well tolerated, patients can:
  • Try a different iron formulation 
  • Take iron with food or at night 
  • Use a "start low and go slow" approach, gradually increasing the dose as tolerated ​

​​​​Refer individuals who do not meet the above criteria to BC Women'​s Obstetric Internal Medicine Clinic or BC Women’s Hematology Clinic​.

​​Referral steps

1​
Assessment

Assess whether your pregnant patient meets all the criteria for outpatient iron infusion ordering, after the effective trial of oral iron.

2Place the order for iron infusion via CST

Use Cerner Remote Access via NetScaler Gateway and complete the following steps:
  1. Select "Pre-Outpatient in a Bed" encounter (BCW Urgent Care) 
  2. Go into Orders and Select "OB AMB Perinatal Iron Sucrose Infusion (Day of Treatment)"
  3. Select visit: "Future Outpatient Visit" and Start Time: "Est. start"  
  4. Click on the plus (+) beside "Medication Infusion (Dose 1 to 3)"
  5. Using the drop-down, change the 'Action' on Dose 2 and 3 to "Do not order"
  6. Leave the Scheduling order (at the bottom) as "Order now"—without it, we cannot book your patient's appointment 
  7. Click "Orders for Signature" 
  8. Click "Sign" 
  9. Select "BCW Infusion Clinic" as the scheduling location 
  10. Click "Submit" 
  11. Choose the Scheduling Priority from the drop-down as "Within 4 Weeks"
  12. Choose an Alt. Amb Scheduling Location from the drop-down as "BCW Infusion Clinic"
  13. Click "Sign" 

After the orders are placed

A nurse reviews and books the orders as received. The clinic will contact patients directly to confirm their appointment date and time. All appointments take place in the morning, and appointment lengths are four to five hours. Your patient can find more details on the Iron Infusion Service page​.

Follow-up

Providers may retest the patient’s hemoglobin and ferritin two weeks after the iron infusion to determine whether a subsequent iron infusion dose is needed.

Contact

Iron Infusion Service 
Maternity Ambulatory Program 
Entrance 93, BC Women’s Hospital + Health Centre
​4500 Oak Street
Vancouver, BC 
V6H 3N1​​

Phone: 604-875-3030