Intravenous Iron Sucrose: Safety and Effectivensess in Pregnant Women with Moderate to Severe Anemia. (original) (raw)
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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.
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.
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 Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy and major contributory factor to maternal morbidity and mortality. Objective of present study was to evaluate the response and effectof parenteral iron sucrose complex therapy in iron deficiency anemia in pregnancy.Methods: A prospective observational study was conducted at GMERS Medical College, Dharpur-Patan over a period extending from September 2014 to August 2017. A total of 150 Antenatal women, between 26-32 weeks of pregnancy with hemoglobin between 5-9 gm% were selected for study by purposive sampling. They were given intravenous iron sucrose complex in a dose of 200 mg (2 ampules of 5 ml each) in 100 ml normal saline over a period of 15-20 minutes, on alternate day. Repeat CBC was done after a period of 6 weeks.Results: Age range of the patients was 20 to 34 years. Out of total 150 women, 72 women (48%) were in age group of 20-24 years. 64.6% women had 27-29 weeks of pregnancy. ...
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.
Tzu Chi Medical Journal, 2019
Objective: The prevalence of anemia during pregnancy is as high as 80% in some sections of the Indian population. Iron therapy in different forms has been found to alleviate anemia and yield good fetomaternal outcome. This study aims to evaluate the efficacy of intravenous iron sucrose (IVIS) versus oral iron in treating anemia among the antenatal mothers attending a tertiary care center of Northeast India. Materials and Methods: One hundred women between 18 and 28 weeks of gestation with diagnosed iron-deficiency anemia and hemoglobin (Hb) of 7-10.9 g/dL were enrolled to be administered either oral ferrous sulfate 200 mg twice daily or requisite dose of IVIS 100 mg in 100 ml normal saline on alternate days. Hb and hematocrit were measured at the time of enrollment, 4 th week, and 8 th week of therapy. Acceptability of both the drugs based on like and dislike after interviewing the study participants was recorded. Adverse drug reactions, gestational age at delivery, and neonatal birth weight were also noted in both the groups. The results were analyzed by Student's t-test and Chi-square test. Results: Hb and hematocrit values were found to be increased in both the groups at 4 th and 8 th weeks. When both the groups were compared, the rise in the values was higher in the iron sucrose group (at 4 th week P = 0.01 and at 8 th week P = 0.00). The number of participants who reached target Hb levels at 4 weeks was 41 (82%) with oral iron and 48 (96%) with iron sucrose. In the iron sucrose group, no adverse effects were observed, suggesting its safety, and the acceptability and newborn birth weight were noted to be higher. Conclusion: IVIS was found to be more effective than oral iron therapy in treating antenatal anemia with no serious adverse drug reactions.
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.
Innovative Publication, 2016
Background: Efficient treatment of iron deficiency anaemia in pregnant women would lead to a considerable reduction in the risk factors, affecting maternal and fetal outcome. Patients and Methods: This prospective study was carried out in 84 women between 20 to 34 weeks of pregnancy with established iron deficiency anaemia and haemoglobin 6-10g/dL. They were randomised to receive either oral or intravenous iron in required dose. Haemoglobin and ferritin levels were measured at recruitment and after 4 weeks of therapy. Adverse drug reactions were also noted in both the groups. Results were analysed by student's t-test. Results: The mean increase in haemoglobin values with IV sucrose group was 1.26 ±0.58g % as compared to 0.78 ±0.37 gm% in oral iron group after 4 weeks of oral iron therapy (p<0.03). Similarly, The mean increase in ferritin values with IV sucrose group was 12.00 ± 11.77ng/ml as compared to 6.50 ± 9.53ng/ml in oral iron group (p<0.02). Conclusion: This study indicates iron sucrose not only treats but also corrects iron stores which are not seen with oral iron.
International Journal of Research in Medical Sciences
Background: Iron deficiency is a leading cause of anemia in pregnancy. The standard treatment in majority of the institutions is oral iron, with blood transfusion reserved for severe or emergency cases. However, it is unreliable in the treatment of severe anemia. The aim of this study was to compare the efficacy and safety of intravenous iron sucrose and oral iron administration for the treatment of iron deficiency anaemia in pregnancy. Methods: Hundred women with gestational age between 30 and 34 weeks with established iron deficiency anaemia with hemoglobin between 6-8g/dL were randomized to receive either oral ferrous sulphate 200 mg thrice daily or required dose of intravenous iron sucrose 200 mg in 200 ml NS on alternate days. Hemoglobin was measured at recruitment and on 2nd week, 4th week and at 37 weeks. Adverse drug reactions were also noted in both the groups. Results were analyzed by student’s t-test and Chi-square test. Results: Haemoglobin values varied significantly wi...
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...