International Journal of Gynecology SC Obstetrics 52 (1996) 33-36 lmuu&Mlkrrld GYNECOIANY & OBSTETRICS Article Screening for anemia in pregnancy with copper sulfate densitometry L.R. Pistorius*, M. Funk, R.C. Pattinson, G.R. Howarth Department of Obsretrics and Gynecology, Kalafong Hospital and University of Pretoria, Pretoria, South Africa Received 17 May 1995; revision received 8 August 1995; accepted 15 August I995 Abstract Objective: The copper sulfate method of screening for anemia was evaluated to determine its accuracy in antenatal patients. Method: In an antenatal clinic in a tertiary referral center, which also serves a local urban black community, 100 antenatal patients were prospectively tested for anemia by Coulter hemoglobin analysis in comparison with the copper sulfate test. The respective accuracy and costs of the tests were evaluated. Results: Once initial technical difftcul- ties had been overcome, the copper sulfate test proved accurate in detecting a hemoglobin level < 10 g% in pregnancy (sensitivity 94%, specificity 95%, positive predictive value 80%, negative predictive value 99%). The cost of the copper sulfate test is estimated to be less than 0.3% that of the Coulter test. Conclusion: The copper sulfate test is accurate and inexpensive, and can be recommended for screening for anemia in pregnancy. Keywords: Pregnancy; Anemia; Screening; Copper sulfate 1. Introduction In pregnancy the hemoglobin concentration is lowered as an effect of a disproportionate increase in plasma volume relative to the increase in red cell mass. This apparent anemia is a normal physiologic phenomenon and is probably beneficial to the mother and fetus [l]. However, true anemia in pregnancy is associated with an in- creased perinatal mortality and might be a direct or indirect contributor to a significant proportion of maternal deaths in the developing world [2]. l Corresponding author, Fax: +27 12 3739031 Screening for anemia in pregnancy is therefore considered an essential part of antenatal care [2]. As the clinical diagnosis of anemia is notorious- ly inaccurate [3,4], different objective methods are in use to screen for it. These include using a por- table hemoglobinometer such as the BMS hemoglobinometer (Premed, Pretoria, South Africa, microhematocrit estimation, and even a Coulter count. Whereas these methods are ac- curate [5,6], they are expensive and require a power source as well as technical support in case of instrument malfunction. In the search for tech- nology appropriate to the developing world, con- sideration should be given to the copper sulfate 0020-7292/96/$15.00 0 1996 International Federation of Gynecology and Obstetrics SSDI 0020-7292(95)02559-U