A prospective comparative study on 521 pregnant women (≥ 32weeks) with iron deficiency anemia (IDA) between July, 2019 and September, 2019 at Kasralainy hospital in Egypt, to evaluate adaptation of the fetus to withstand maternal IDA by Doppler parameters, to know the cut-offs of maternal hemoglobin at which complications exist, and to evaluate the effect of treatment (oral iron, parenteral iron or blood transfusion) on fetal hemodynamics and neonatal outcome by birth weight and APGAR score at delivery.

Groups subjected to Doppler examination of umbilical artery, middle cerebral artery (MCA) and renal artery on admission, ten days after treatment by oral iron for mild anemia parenteral iron for moderate anemia, or blood transfusion for severe anemia, again at delivery. Results showed a significant difference regarding Doppler parameters of umbilical artery, renal artery and MCA on admission, ten days after treatment and at delivery explained by vasodilatation of the MCA (brain sparing effect) in moderate and severe anemia, a higher percentage of IUGR in group (C). Treatment corrected Doppler changes and decreased fetal and neonatal complications attributed to anemia especially in severe anemia.