DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20173462

Intravenous versus oral iron therapy in treatment of postpartum anaemia

Neelima Agarwal, Preeti Sharma

Abstract


Background: Postpartum iron deficiency anaemia (IDA) is common in women. Most women are treated with either oral iron supplementation or blood transfusion. Hence, the aim of our study was to compare the effect of treatment with either oral ferrous sulphate or intravenous ferrous sucrose on postpartum IDA.

Methods: 100 postpartum women with proven iron deficiency anaemia with hemoglobin <9gm/dl and serum ferritin <15 µgm/l were included in the study. They were randomized to receive either oral ferrous sulphate 200 mg twice daily for 6 weeks (group 1) or intravenous ferrous sucrose 200 mg, two to three doses given on alternate days (group 2). Total iron deficit was calculated using a standard formula. Target hemoglobin was 11 gm/dl. Results were analysed by the students t-test and chi-square test. Hemoglobin, hematocrit, red cell indices and ferritin were measured on day 2-3, 1-2 weeks and 6 weeks postpartum

Results: By 1-2 weeks, hemoglobin level in women treated with intravenous iron had risen from 7.81±0.849 to 9.88±0.760 gm/dl which was more than those treated with oral iron (p<0.01); although by 6 weeks, there was no significant difference between the two groups. Ferritin levels rose rapidly in those treated with intravenous iron and remained significantly higher than in those treated with oral iron (p<0.01).

Conclusions: Intravenous iron sucrose increases the hemoglobin level more rapidly than oral ferrous sulphate in women with postpartum IDA. It also replenishes iron stores more rapidly.

 


Keywords


Ferritin, Iron sucrose, Postpartum iron deficiency anaemia

Full Text:

PDF

References


Dodd J, Dare MR, Middleton P. Treatment for women with postpartum iron deficiecy anaemia. Cochrane Database Syst Rev. 2004;4: CD004222.

Bhandal N, Russell R. Intravenous versus oral iron therapy for postpartum anaemia. BJOG. 2006;113:1248-52.

Studd J. Current Progress in Obstetrics and Gynaecology. 2012:1.

Bayoumeu F, Buisset C. Iron Therapy in iron deficiency anaemia in pregnancy: intravenous route versus oral route. Am J Obstet Gynecol 2002;186(3):518-22.

Al-Momen AK, Al-Meshari A, Al-Nuaim L, Saddique A, Abotalib Z, Khashogji T, Abbas M. Intravenous iron sucrose complex in the treatment of iron deficiency anemia during pregnancy. Eur J Obstet Gynecol Reprod Biol. 1996;69(2):121-4.

Broche DE, Gay C, Armand-Branger S, Grangeasse L, Terzibachian JJ. Severe anaemia in the immediate post partum period. Clinical practice and value of intravenous iron. Eur J Obstet Gynecol Reprod Biol. 2005;123:521-827.

Bodnar LM, Cogswell ME. Low income postpartum women are at risk of iron deficiency. J Nutr. 2002;132:2298-302.

Perewusnyk G, Breymann C. Parenteral iron therapy in obstetrics: 8 years experience with iron sucrose complex. Br J Nutr. 2002;88:3-10.

Westad S, Backe B, Salvesen KÅ, Nakling J, Økland I, Borthen I, et al. A 12-week randomized study comparing intravenous iron sucrose versus oral ferrous sulphate for treatment of postpartum anaemia. Acta Obstet Gynecol Scand. 2008;87:916-923.

Goddard AF, James MW, McIntyre AS. Guidelines for the management of iron deficiency anaemia. Br Soc Gastroenterol. 2005;1-6.