The Role of Intravenous Iron Sucrose Complex in Treatment of Iron Deficiency Anemia in Pregnant Women (original) (raw)
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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.
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.
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
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...
2022
Aims & Objectives: To determine the effectiveness and safety of IV Iron sucrose therapy in antenatal women with moderate to severe Iron deficiency anaemia. Methodology: It is a retrospective study with secondary data analysis. We have analyzed the data collected from January 2019 to December 2019 at the Nootan general hospital, Visnagar, Gujarat, India. Analysis of antenatal women with moderate to severe anaemia (Hb 6 to 8gm%) in the second trimester and early third trimester(20 to 34weeks of gestation) are done during their routine antenatal care who were prescribed Intravenous Iron sucrose in a standard-dose of 1000 mg given as 200 mg on alternate days after confirming the iron deficiency anaemia. Effectiveness of the therapy has been studied by comparing the Hb level at the point baseline where start of the treatment and 4 week or more after the last treatment was given (endline). The safety profile of the Original Research Article
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. ...
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.
IOSR Journals , 2019
Introduction:-In India,women become pregnant with low baseline hemoglobin levels resulting in high incidence of moderate to severe anemia in pregnancy where oral iron therapy cannot meet the requirement. Pregnant women with moderate to severe anemia are to be treated with parenteral iron therapy. This study was done to evaluate the safety and effectiveness of intravenous iron sucrose given to pregnant women with proven iron deficiency anemia. Materials And Methods:-A prospective observational study was conducted in 98 pregnant women attending antenatal checkup at primary health center with documented low Hb levels between 6-9 gmsHb.They were treated with intravenous iron sucrose 200mg thrice weekly calculating the dose required.Statistical analysis of the data was done by using paired T TEST. Results:-Mean Hbrised from 7.9-11.5 after 8 weeks of iron infusion therapy.A significant rise in serum ferritin values is noted.Other parameters including Serum Iron,TIBC,Reticulocyte Count and MCV were also improved significantly without any Adverse drug reactions. Conclusion:-Intravenous iron sucrose therapy was effective in measuring Hb,S.Ferritin and other hematological parameters in pregnant women with moderate anemia.