Hello, Firstly, the cause of the low hemoglobin should be determined. In pregnancy due to increased blood volume and increased fetal demand iron deficiency anemia is seen. In your wife s case, perhaps it is iron deficiency as she recovered with blood transfusion in her previous pregnancy. Even in early pregnancy, provided there is no nausea and gastritis, iron supplements can be given in different forms. Eliciting the proper cause and getting the right treatment early can improve her condition vastly. Please consult your doctor for further management. Take care.