Treatment of Vitamin A Deficiency in Pregnancy

Vitamin A deficiency during pregnancy requires a clinically careful approach: the stage of illness at presentation determines both the urgency and the nature of the intervention, with fetal safety as a central constraint throughout.

Clinical scenario: Pregnant patient with vitamin A deficiency. Treatment strategy is stage-dependent — the approach differs substantially depending on whether presentation involves early visual symptoms or corneal involvement.

Treatment approach (overview): Oral retinol (vitamin A) is the treatment of choice, with the dosing strategy governed by the stage of illness. Fetal teratogenic risk shapes the limits of treatment — except in cases of corneal involvement, where the risk of irreversible blindness alters the clinical calculus. The complete stage-by-stage regimen is in the full protocol.

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References

In pregnant women, treatment varies according to the stage of illness:
Hemeralopia or Bitot's spots: 10 000 IU once daily or 25 000 IU once weekly for at least 4 weeks. Do not exceed indicated doses (risk of foetal malformations).
If the cornea is affected, risk of blindness outweighs teratogenic risk. Administer 200 000 IU once daily on D1, D2 and D8.
Corneal lesions are a medical emergency. In addition to the immediate administration of retinol, treat or prevent secondary bacterial infections with 1% tetracycline eye ointment, one application 2 times daily (do not apply eye drops containing corticosteroids) and protect the eye with an eye-pad after each application.

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