Abstract
Anemia is common in pregnancy and iron deficiency is the most common cause. Oral iron is the standard therapy, but there is a problem of adherence due the gastrointestinal side effects. Intravenous iron therapy has more advantages, therefore, intravenous iron therapy is the best treatment for pregnant women during the third trimester. We reviewed the statistics of deliveries of the fiscal year 2012, the cases of anemia in pregnancy as in patients provided by Record Room from the calendar year 2012 and the patient cases that used sodium ferric gluconate complex in sucrose injection (FERRLECIT) from the Obstetrics/Gynecology Ward from the fiscal year 2012 provided by the Department of Pharmacy of the Ashford Presbyterian Community Hospital (APCH). A review of the records of pregnant women receiving iron dextran injection (INFeD) intravenously in our ambulatory infusion center was also performed. Our data confirmed that either presentations elevated the hemoglobin and they were well tolerable. Iron sucrose is the preferred and it has demonstrated a high success rate. I recommend considering this alternative earlier at the third trimester and establishing guidelines using parenteral iron and erythropoietin in combination in refractory cases.
Highlights
Anemia is a frequent condition during pregnancy, among women from developing countries who have insufficient iron intake to meet increased iron needs of both the mother and the fetus
I reviewed the statistics of deliveries of the fiscal year 2012 (July 2012 to June 2013) provided by Labor & Delivery Room of the Ashford Presbyterian Community Hospital (APCH), the cases of anemia in pregnancy (ICD-9 codes 648.23, 648.21) as in patients provided by Record Room of APCH from the calendar year 2012 (January 1 to December 31 of 2012), and the in patient cases that used sodium ferric gluconate complex in sucrose injection (FERRLECIT) from the Obstetrics/Gynecology Ward of the same hospital from the fiscal year 2012 provided by the Department of Pharmacy of APCH
There were a total of 3,643 deliveries in the fiscal year 2012 at APCH with values between 230-331 deliveries per month for an average of 280 deliveries per month
Summary
Anemia is a frequent condition during pregnancy, among women from developing countries who have insufficient iron intake to meet increased iron needs of both the mother and the fetus. Gestational anemia has been prevented with the provision of daily iron supplements throughout pregnancy, but adherence to this regimen due to side effects, interrupted supply of the supplements, and concerns about safety among women with an adequate iron intake, have limited the use of this intervention. Intermittent (i.e. one, two or three times a week on non-consecutive days) supplementation with iron alone or in combination with folic acid or other vitamins and minerals has recently been proposed as an alternative to daily supplementation [1]. Intermittent iron and folic acid regimens produce similar maternal and infant outcomes at birth as daily supplementation but are associated with fewer side effects. Women receiving daily supplements had increased risk of developing high levels of hemoglobin (Hb) in mid and late pregnancy but were less likely to present mild anemia near term.
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