Efficacy and safety of intravenous iron sucrose versus oral iron in pregnant women with mild to moderate iron deficiency anaemia (original) (raw)
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Background: Nutritional anaemia is one of major the contributory factor in high maternal mortality and morbidity in most of the countries. Iron deficiency is the principle cause for nutritional anaemia. Objective: To compare the efficacy of oral iron therapy with intravenous iron therapy in the treatment of iron deficiency anaemia during pregnancy. Methodology: This comparative study was undertaken at a tertiary care teaching hospital among one hundred and ten pregnant anaemic patients whose baseline hemoglobin and serum ferritin levels were recorded prior to treatment. The patients were divided into two groups; group A (n=58) received intravenous iron-sucrose and group B (n=52) received oral iron therapy. The patients were followed up for further investigations and side effects. Results: Out of 110 patients, 50% had mild anaemia (10.9-10 gm%), 34.5% patients had moderate anaemia (7-9.9 gm%) and 15.5% (6-6.9 gm%) patients had severe anaemia. Group A showed statistically significant rise in haemoglobin regardless the severity. Conclusion: Intravenous iron-sucrose administration increased haemoglobin level and serum ferritin levels more rapidly, without any serious adverse effect in comparison with oral ferrous sulphate in women with iron deficiency anaemia in pregnancy.
International Journal of Clinical Obstetrics and Gynaecology, 2021
Background: Iron deficiency anemia (IDA) is the most common medical problem in pregnancy. Parenteral iron is a useful treatment, although iron dextran use decreased due to anaphylaxis. Iron sucrose is a newer agent that has overcome the shortcomings of iron dextran. Objective: The aim of this study was to compare the safety and efficiency of intravenous iron sucrose with oral iron administration for the treatment of iron deficiency anaemia in pregnancy. Materials and Methods: 100 women with gestational age between 14 and 35 weeks with iron deficiency anaemia & Haemoglobin between 6-8g/dL were randomised to receive either oral iron (ferrous sulphate) 200 mg thrice daily or required dose of intravenous iron sucrose. Haemoglobin, haematocrit, mean corpuscular volume, reticulocyte count were measured at recruitment and on 2nd week, 4th week and at 37 weeks of gestation. Adverse drug reactions were also noted in both these groups. Results: Haemoglobin values varied significantly with time between the two groups at second week, 4th week and at 37 weeks. The mean difference in mean corpuscular volume from the recruitment value was not significant at 2nd week of treatment. When compared to iron sucrose group, oral iron group had significant gastro-intestinal adverse effects. Conclusion: Intravenous iron sucrose treated iron deficiency anaemia of pregnancy faster, and more effectively than oral iron therapy, with no serious adverse drug reactions.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Iron deficiency anemia is the most common form of anemia and nutritional disorder worldwide. Oral iron therapy and blood transfusion has many drawbacks like noncompliance and risk of transmittable infections and transfusion reaction. The modern alternative therapy is treatment with intravenous iron. Present study compares the efficacy, safety and tolerability between intravenous iron sucrose and oral iron in iron deficiency anemia during 20-36 weeks of pregnancy.Methods: It was a randomized controlled study between December 2017 to September 2019. 200 patients attending antenatal OPD in Al Ameen Medical College, with haemoglobin levels between 7-9.9 gm/dl and serum ferritin of <15 ng/ml were enrolled. In intravenous group, 200 mg iron sucrose in 100ml normal saline was infused alternate day till the required dose was met. The oral group received 200 mg of oral iron ascorbate along with folic acid 1.5 mg per day for 6 weeks. Treatment efficacy was assessed by Hb and s...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019
Background: Iron deficiency anaemia in pregnancy is a common medical problem throughout India with the burden of disease impacting on both mother and the newborn. It is also responsible for increased incidence of premature births, low birth weight babies and high perinatal mortality. Intravenous iron sucrose and oral iron therapy are the primary therapeutic modalities for management of iron deficiency anaemia during pregnancy, but its efficacy during pregnancy is still a matter of argument among healthcare personnel. Therefore the objective of this study is to compare the effect of oral iron and intravenous iron sucrose on hemoglobin and other blood indices among pregnant females with iron deficiency anemia. Methods: Randomized clinical trial was conducted among 400 females between 20 to 34 weeks gestation with iron deficiency anemia who were managed either with oral ferrous sulphate or intravenous iron sucrose therapy. Z test was used for statistical analysis for significance with 95% confidence interval. The hemoglobin and blood indices levels before and after initiating treatment in both groups were compared. Results: Intravenous and oral; both the treatments were associated with increment in hemoglobin but this rise was significantly more in the intravenous group than in oral. Comparing participants with low pretreatment hemoglobin among both groups, participants in the intravenous group were better benefited than oral due to respective treatment. Conclusions: Intravenous iron therapy is much effective in correcting iron deficiency anemia in pregnancy than oral iron therapy. It restores iron stores more promptly. Also intravenous iron is better tolerated compared to oral iron.
Effectiveness of Intravenous Iron Sucrose versus Oral Iron in Iron Deficiency Anemia in Pregnancy
2015
Anaemia in pregnancy is a public health problem in India, where nutrition mass education and availabiliaty and blood are far from satisfactory. It is paradoxical that the while iron is one of the least expensive and most readily available medicinal substance, its deficiency particularly in female population still presents serious problems. Low availability and absorptions of iron and repeated and closely spaced pregnancies place a constant drain on the iron stores of pregnanct women resulting in development of iron deficientl anaemia. All women who were attending antenatal check ups were asked to participate diagnosis of moderate deficiency was done by Hb and Sr. Ferritin and those who have fulfilled the criteria were enrolled after written informed consent. All patients were asked to come at day 14 and day 28 for laboratory tests. On day 14, Hb was done and on day 28 CBC, Sr. Feritin were done and at delivery Sr. Ferritin, CBC were done. The prevalence of anaemia was similar in both supplemented (88.1%) and the unsupplemented groups (87.5%) suggesting that the supplement provided was not adequate or the compliance was poor. The choice of treatment of iron deficiency anemia is oral iron replacement because it is the safest and least expensive.
Comparison of intravenous iron sucrose with oral iron in pregnant women with iron deficiency anaemia
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Iron deficiency anaemia (IDA) is a major public health problem all over the world. Pregnant women are the most vulnerable due to its effect on maternal and neonatal morbidity and mortality. Prevalence of IDA in pregnancy is estimated to be 35-75% (average 56%) in nonindustrialized countries and 18% in industrialized countries according to WHO report. 1 It is responsible for 40-60% maternal death in non-industrialized countries directly or indirectly. (2,3) In India the prevalence of IDA in pregnancy has been reported to be 57.9% (54.6% urban and 59% in rural) by National Family Health Survey-3 (NFHS) with a wide variation of incidence from state to state. 4 According to WHO data presented at Federation of International Obstetrics and Gynaecology (FIGO) meeting in 2003 in Chile around 500,000 maternal deaths and 20,000,000 maternal morbidity cases per year are related to iron deficiency anaemia. FOGSI-WHO study on maternal morbidity revealed 64.4% of women who died, had hemoglobin less than 8 gm% and 21.6% had hemoglobin 5 gm%.
2014
A high proportion of women in both industrialized and developing countries become anaemic during pregnancy. Anaemia is associated with adverse fetomaternal outcome and is estimated to contribute 20% of all maternal deaths Oral iron supplementation is commonly being promoted for correction of anaemia however the major problems faced are gastrointestinal side effects and slow rate of action in correcting anaemia. Intravenous iron supplementation using iron sucrose besides having less gastrointestinal side effects is more efficacious in correcting anaemia and replenishing the iron stores. This prospective study was conducted to compare the efficacy of intravenous Iron sucrose to oral iron in the treatment of moderate anaemia in 200 pregnant women who fulfilled the inclusion criteria in the Postgraduate Department of Obstetrics and Gynaecology, GMC Srinagar (tertiary care hospital). Both the groups showed significant improvement in all the parameters however intravenous group showed ach...
IAR Consortium, 2022
Background: Iron deficiency anemia during pregnancy is associated with an increased risk of low birth weight, preterm birth, maternal and perinatal mortality and poor Apgar score.The present study was done with the objective to evaluate the efficacy and safety ofIntravenous Iron Sucrose in the treatment of iron deficiency anemia in pregnancy. Material & Methods: This was a prospective study conducted in the department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College Shimla from 1st June 2019 to 31st May 2020. Forty three antenatal women with iron deficiency anemia were included in the study. The subjects were given intravenous Iron Sucrose and Response of treatment in terms of hemoglobin, packed cell volume, serum iron, serum ferritin and total iron binding capacity was assessed at 2 and 4 weeks on follow up. Results: In our study,it was observed that maximum subjects were in the age group of 21-25 years and belonged to class III (lower middle class) according to modified Kuppuswamy scale (69.8%).Out of 43 participants, 25.6% received dose of ISC between 801 - 850 mg. The mean dose of ISC was 831.26 mg. The mean value of baseline hemoglobin, reticulocyte count, packed cell volume, serum iron, serum ferritin and total iron binding capacity was found to be 8.36 g/dL, 0.74%, 25.26%, 36.17 ug/dL, 10.514 ng/dL and 493.460 ug/dL respectively. The mean value of hemoglobin, reticulocyte count, packed cell volume, serum iron, serum ferritin and total iron binding capacity at two weeks post infusion was found to be 10.03 g/dL, 2.228%, 31.021%, 92.758 ug/dL, 116.114 ng/dL, and 410.61 ug/dL respectively. The mean value of haemoglobin, reticulocyte count, packed cell volume, serum iron, serum ferritin and total iron binding capacity at four weeks was found to be 11.002 g/dL, 2.507%, 34.17%, 111.03 ug/dL, 96.367 ng/dL, and 380.540 ug/dL respectively. There was a very strong evidence against null hypothesis and there was significant difference in all the parametersat four weeks (p<0.001). Conclusion: The present study concluded thatintravenous iron sucrose is efficacious in replenishment of iron stores in a short duration of time and improvement of hemoglobin levels and had good safetyprofile.
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Anaemia in pregnancy continues to be a major public health problem with 54.96% of the pregnant population suffering from it in our setup. Despite the National Anaemia Prophylaxis Programme, anaemia complicating pregnancy continues to be a widespread problem with adverse effects on maternal and foetal outcome. The aim of the study is to find out an alternate iron therapy in the form of intravenous iron-sucrose and to determine its therapeutic effectiveness, safety and compliance in the management of anaemic expectant mother and to compare it with that of conventional oral iron therapy. MATERIALS AND METHODS The study was a randomised controlled clinical trial carried out in the Department of Obstetrics and Gynaecology in collaboration with the Department of Biochemistry, Regional Institute of Medical Sciences (RIMS), Imphal. 100 pregnant women in second or third trimester with mild or moderate anaemia were selected, 50 as study group (intravenous iron) and 50 as controls (oral iron). Initial evaluation included complete blood count and serum ferritin level and reevaluated on the 14 th and 28 th day of initiation of therapy. RESULTS Majority of patients (42%) in the study as well as control group were between 26-30 years of age. The mean ± SD increase in haemoglobin and ferritin levels on 28 th day were 2.66 ± 0.34 gm/dL and 27.65 ± 1.80 ng/mL in study group and 1.55 ± 0.23 gm/dL and 16.89 ± 0.76 ng/mL in control group respectively, both of which were statistically significant. CONCLUSION The mean haemoglobin and serum ferritin levels throughout the treatment were significantly higher in the intravenous ironsucrose group than in the orally administered iron group and significantly higher number of patients achieved the target haemoglobin of 11.0 gm/dL after 28 days of treatment. This reduces the blood transfusion rates in pregnant women with severe anaemia near term.
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Anaemia is a major public health problems in developing world. Anaemia is a pathological condition in which the oxygen binding capacity of red cells is insufficient to meet the body's need. Anaemia is the most common medical disorder complicating pregnancy. It may antedate pregnancy, often aggravated by pregnancy and delivery. More than 70% of pregnant women suffer from nutritional anaemia in South East Asia. Of all the anaemias diagnosed during pregnancy 75% are due to iron deficiency. The prevalence of anaemia is 55% among expectant mothers across the world and the incidence in India varies from 40 –90% according to WHO reports. Materials and Method: The prospective study was carried out in the department of obstetrics and Gynecology, in Konaseema institute of medical science Amalapuram during 2015-16 to access the efficacy, safety and compliance of injectable iron sucrose in pregnancy with mild, moderate and severe iron deficiency anaemia for a period of 12 months from Nov 2015 to Nov 2016. Result: Among the total number of 104 patients studied, mean age of the study group was 25.4 ± 3.26 years. Teen age pregnancies with anaemia formed 5.7% of the study group. Most cases, i.e. 77.9% were between 20 – 30 years. Elderly gravidas comprised 16.4%. The mean Hb% on day of Admission was 7.670 gm% which raised to 10.388 on day 28 of completion of iron therapy. Thus the mean Hb rise on day 28 was 2.718 gm% which is statistically significant (p value being 0.000).The Hb level at 38 weeks of gestation is 9.162 which is significantly higher when compared with Hb value on the day of admission (p value being 0.000). Discussion: Haemoglobin values varied significantly with time between groups (interaction effect, p<.001). The change in haemoglobin from baseline was significantly higher on the 14 th (p=.004) and 28 th (p=.031) days. Ferritin values were higher in the patients receiving intravenous iron throughout pregnancy. No serious adverse drug reactions were observed. Fetal weight and hospitalization time were similar in the 2 groups. Blood transfusion was required for only one patient in the oral group. Thus, it is observed that iron deficiency anemia of pregnancy treated with the intravenous iron had restored iron stores faster and more effectively than oral iron with no serious adverse reactions.