Ferritin Levels Following Postpartum Hemorrhage: A Case Series

Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality, complicating 2% to 4% of US deliveries and exacerbating iron deficiency anemia. Ferritin is the primary biomarker for iron deficiency (ferritin <30 µg/mL), yet its reliability as a marker of iron deficiency in the acute setting of PPH remains uncertain because it also functions as an acute-phase reactant. In this case series, 10 iron-deficient women who experienced PPH following cesarean delivery all maintained ferritin <30 µg/mL postoperatively. Ferritin remained a reliable marker for iron deficiency following acute PPH in women with pre-existing iron deficiency. These observations highlight the need for larger, prospective studies to further validate ferritin's reliability following PPH.