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Why would hemoglobin keep dropping despite taking needed supplements?

My wife is pregnant, she had a hematology test 3 months ago, her hemoglobin level was 10 back then, her doctor prescribed some supplements that had a bunch of minerals and vitamins including iron, she is in her 28th week now, she did the test again and her hemoglobin level dropped to 7.7 despite all the supplements that she is taking, there is no internal hemorrhage as far as the tests can show, so is there an issue other than vitamin or iron deficiencies that might explain the drop in hemoglobin? When is a blood transfusion required? Or is it safe to have a blood transfusion as a precaution?

P.S: we tested iron levels and it turned out to be 38, despite the continues intake of at least 30 mg of iron for the past 3 months

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15695260 tn?1549593113
Hello and welcome to MedHelp's forums.  Thank you for your question and congratulations on the pregnancy.  Please do consult with her doctor about this as your best source of information that is directly in relation to your wife's health history.  In general though, a drop in hemoglobin during pregnancy is normal and often happens.  However, a significant drop can be more alarming.  Here is an article that describes anemia (low hemoglobin) in pregnancy.  https://www.medicinenet.com/anemia_in_pregnancy/views.htm.  If your wife started the pregnancy with low hemoglobin which can happen if her period prior to becoming pregnant was heavy, it makes it more pronounced and problematic during the pregnancy. I do want to also point out that anemia also increases as pregnancy continues from the first to third trimester. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779156/.  This article talks more about anemia in pregnancy.  

Now I believe you are saying your wife's hemoglobin is at 7.7.  If it drops to 7 or below, then her doctor will likely take further action such as a blood transfusion. How is her B12?  That should also be looked at. Hopefully her doctor has a plan to help increase her hemoglobin. Again, she needs to be eating iron rich foods such as leafy green vegetables, dried fruit, etc.  

We, again, encourage you to work with your doctor on this issue.  Please let us know how she is doing.
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Thanks for the time you took to provide the detailed response, We are definitely consulting with her doctor, when we informed her doctor of the blood tests she prescribed her  a course of "saferon" an iron injection with 100 mg iron dosage.
I surely do not know more than her doctor, but my common sense tells me if she's been taking 30 - 40 mg of iron every day for the past 3 months, and yet her hemoglobin and RBC kept dropping drastically, another iron injection or supplement is not going to help the issue, the doctor ordered more scans to make sure she is not suffering from placenta abruption and the results came out fine.

The only thing is, I am not planning on waiting for her hemoglobin level to drop to 7 to take action! And I cannot say I am 100% satisfied with how her doctor is handling the issue, she should have ordered a blood test earlier when she realized she is anemic. I will definitely go to another doctor for a second opinion. There are other possibility that makes her lose blood internally, I will most likely get her an occult blood test, hence, I'm looking for more reasons why her hemoglobin would drop "Other than iron deficiency".

Thanks again
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