Volume : 7, Issue : 6, June - 2018

Intravenous Iron sucrose compared to oral Iron in correction of Iron deficiency Anemia during pregnancy

Dr. V. Mary Snygdha, Dr. R. Indira Priyadarshini

Abstract :

<p>&nbsp;AIMS AND OBJECTIVES: 1. To compare the efficacy of intravenous sucrose over oral iron in treatment of iron</p> <div>de􀃶ciency anemia.</div> <div>2. To study the adverse effects of intravenous iron sucrose over oral iron.</div> <div>MATERIALS AND METHODS: The study was conducted over a period of 2 years from 2015 January to 2016 December in the antenatal</div> <div>clinic of Government General Hospital, ACSR Medical college Nellore .</div> <div>This is a prospective comparative study involving two groups of patients. 100 women around 26 weeks of Gestational age were selected in</div> <div>each group. I choose mild to moderate anaemia in 2nd trimester since it may worsen severe anemia in 3rd trimester and its associated</div> <div>complications.</div> <div>SUMMARY: In my study I studied 200 women with mild to moderate iron de􀃶ciency anemia with&gt; Hb 7gm/dl around 24 weeks of gestation</div> <div>of which 100 women were given intravenous iron sucrose as per the formula weight at 􀃶rst visit (Kgs) (11-Hb%) X 2.4+500mg). The patients</div> <div>were given 200 mg of elemental iron in 100ml of normal saline on alternate days. No testing dose was given. For all the women in the study</div> <div>group deworming was done by albendazole 400mg stat and iron de􀃶ciency was con􀃶rmed by peripheral smear. Hb and PCV are calculated.</div> <div>Oral group received 333mg (100mg elemental iron) twice a day for 100 days. Hb% and PCV were calculated at the time of recruitment.</div> <div>The mean Hb and PCV level in the intravenous group before treatment is 8.026g/dL and 23.58% and after treatment it was 10.84g/dL and</div> <div>31.96% after two weeks respectively after administration of 766.8gms of elemental iron. There is a signi􀃶cant rise in the Hb % level before</div> <div>and after treatment (p&lt;0.001) was calculated by ‘Paired t test‘. The man Hb and PCV level in the oral group before treatment is 8.39g/dL and</div> <div>24.9% and after treatment it was 9.76g/dL and 28.01% after 100days respectively. There is also a rise in the Hb level in the oral iron group but</div> <div>the mean rise in the Hb level is signi􀃶cantly higher in the Intravenous group than oral group( p&lt;0.001) calculated by ‘student t test‘.</div> <div>CONCLUSION: Intra venous route is the preferred mode of improving Hb signi􀃶cantly in mild to moderate iron de􀃶ciency anemia in</div> <div>pregnancy.</div> <div>The iron sucrose complex has minimal side effects and no test dose is required and can be given on a OP basis. This drug can be used where</div> <div>rare blood groups like negative blood group and are safely administered where the blood is not available in the blood bank. Patient has</div> <div>better compliance and less side effects.</div> <div>In oral iron therapy compliance is less and gastro intestinal side effects are more and duration of therapy is more than 3months. In these</div> <div>3months patients can be develop both maternal and fetal complications of anemia. Further in India iron absorption is very low because of</div> <div>worm infestations and many other reasons, mentioned early. Intravenous iron absorption is high because of its low molecular weight.</div> <div>I conclude that Iron sucrose complex is more effective in improving the Hb levels with minimal side effects in a shorter period. This makes it</div> <div>convenient and effective in pregnant iron de􀃶cient women, who are unable to obtain an adequate amount of iron rapidly by oral route.</div>