DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20183771

Comparative study of oral iron (ferrous sulphate) versus intravenous (iron sucrose) therapy in treating iron deficiency anaemia in puerperium

Soniya Vishwakarma, Rajani Rawat, Pragati Dwivedi, Vaibhav Kanti

Abstract


Background: Iron deficiency anaemia is one of the major morbidities during post-partum period. The aim of this study was to compare the efficacy, safety and compliance of intravenous iron sucrose complex with oral Iron therapy in treatment of postpartum anemia.

Methods: 100 postpartum anaemic patients randomized into two groups. In Group I oral iron ferrous sulphate tablets twice daily and in group II 200 mg of iron sucrose on every alternate day up to total calculated dose for 6 weeks. Hemoglobin and serum ferritin were measured on day 0, 2 week and 6 weeks. The side effects in both groups were noted.

Results: Majority of patients are multiparous, illiterate and belonged to low socioeconomic. Mean baseline hemoglobin in oral group (Group I) was 7.90±0.905 gm /dl and in i/v group (Group II) was 7.81±0.849 gm /dl. There was significant rise in hemoglobin and hematocrit in both groups after 2 weeks and 6 weeks. However, efficiency of iron sucrose was greater in between the groups (p value=0.0000). There was a rise in serum ferritin to 58.35±14.537μg/L from 8.30±1,461μg/L after 6 weeks in intravenous group with shorter duration of treatment indicating a high efficacy (p<0.001). Intravenous iron sucrose did not result in any serious adverse reactions.

Conclusions: This study illustrates clearly that intravenous iron sucrose complex is safe, convenient and effective in postpartum anemic women as compared with oral ferrous sulphate.


Keywords


Intravenous iron sucrose, Oral ferrous sulphate, Post-partum anemia

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References


Breymann C. The use of iron sucrose complex for anemia in pregnancy and postpartum period. Semin Hematol. 2006;43 suppl 6:S28-31.

Kalaivani K. Prevalence and consequences of anemia in pregnancy. Indian J Med Res. 2009;130:627-33.

Indian Council of Medical Research. Evaluation of nutritional anaemia prophylaxis programme task force study New Delhi; 1989. Available at: https://www.ncbi.nlm.nih.gov/pubmed/2246014.

Bodnar LM, Cogswell ME, Mc Donald. Have we forgotten the significance of postpartum iron deficiency? Am J Obstet Gynecol. 2005;193(1):36-44.

Perez EM, Hendricks MK, Beard JL, Murray KLE, Berg A, Tomlinson M, et al. Mother-infant interactions and infant development are altered by maternal iron deficiency anemia. J Nutr. 2005;135(4):850-5.

Sharma JB, Soni D. Oxidative stress in pregnancy - Role of iron therapy: oral iron therapy and risk of free radicals. Obstet Gynacol. 2001;6(12):705-6.

Perewusnyk KG, Huch R, Huch A, Breymann C. Parenteral iron therapy in obstretics: 8 years’ experience with iron-sucrose complex. Br J Nutr. 2002;88:3-10.

Kaur P, Kaur G, Bhatia R, Singh J, Aggarwal T, Kaur P. To study the comparison of oral iron versus parenteral iron sucrose in the treatment of postpartum anaemia. J Evolution Med Dent Sci. 2017;6(75):5337-9.

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

Westad S, Backe B, Salvesen KA, Nakling J, Okland I, Borthen I, et al. A 12- week randomized study comparing intravenous iron sucrose verses oral ferrous sulphate for treatment of postpartum anemia. Acta Obstet Gynecol Scand. 2008;87(9):916-23.

Dede A, Uygur D, Yilmz B, Mungan T, Ugur M. Intravenous iron sucrose complex vs. Oral ferrous sulphate for postpartum iron deficiency anemia. Int J Gynaecol Obstet. 2005;90:238-9.

Bayoumeu F, Subiran-Buisset C, BakaNE, Legagneur H, Monnier- Barbarino P, Laxenaire MC. Iron therapy in iron deficiency anemia in pregnancy: Intravenous route versus oral route. Am J Obstet Gynecol; 2002: 186:3: 518-522.

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

Verma S, Inamdar SA, Malhotra N. Intravenous iron therapy versus oral iron in postpartum patients in rural area. J SAFOG DVD. 2011;3(2):67-70.

Breymann C. Treatment of iron deficiency anaemia in pregnancy and postpartum with special focus on intravenous iron sucrose complex. J Med Assoc Thai. 2005;88:108-9.

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

Giannoulis C, Daniilidis A, Tantanasis T, Dinas K, Tzafettas J. Intravenous administration of iron sucrose for treating anemia in postpartum women. Hippokratia. 2009;13(1):38-40.

Seid MH, Derman RJ, Baker JB, Banach W, Goldberg C, Rogers R. Ferric carboxy maltose injection in the treatment of postpartum iron deficiency anaemia: a randomized controlled clinical trial. Am J Obstet Gynecol. 2008;199(4):435:1-7.

Van Wyck DB, Martens MG, Seid MH, Baker JB, Mangione A. Intravenous ferric carboxymaltose compared with oral iron in the treatment of postpartum anemia: a randomized controlled trial. Obstet Gynecol. 2007;110:267-78.