English

Abstract

BACKGROUND: Iron deficiency anemia (IDA) is the commonest medical disorder affecting around 80% of the pregnant females. Iron sucrose has better bioavailability, safety profile and patient compliance than oral therapy. OBJECTIVES: To determine an alternative iron supplementation with better efficacy, compliance and safety in treatment of iron deficiency anemia during pregnancy. METHODOLOGY: Thirty six pregnant women with haemoglobin < 10.0 g/dl and serum ferritin <13µg/l were included. Women received two doses of IV iron sucrose (200 mg). Hemoglobin, reticulocyte count and serum ferritin were estimated at baseline, 14 days and 28 days after treatment. RESULTS: There was a significant increase in hemoglobin levels, reticulocyte count and serum ferritin levels on 14 days and 28 days of treatment. Majority of the patients were free of side effects (80.56%). CONCLUSION: Iron sucrose therapy results in significant improvement of hemoglobin levels and iron stores. Iron sucrose injection is safe and well tolerated. INTRODUCTION: Iron deficiency anemia (IDA) is the commonest medical disorder affecting around 80% of the pregnant females. It is a major contributing factor to maternal morbidity, mortality and high perinatal mortality. WHO defines anemia as hemoglobin level <11gm% and hematocrit <33% in pregnancy. According to National Family Health Survey-3(2005-2006), the prevalence of anemia in pregnancy is 57.9% (1). There is an increased iron requirement of 1240mg during pregnancy (230mg obligate loss, 450mg for expanded RBC volume, 270mg for fetus, 90mg in placental tissue and 200mg lost at delivery). Woman saves 150mg due to amenorrhea and that leaves around 1000mg of iron to be supplemented. The Iron-Folic Acid (IFA) program was launched in India to provide free iron and folate to pregnant women to eradicate IDA. The reasons for failure of IFA program often cited are partial coverage of the population, inadequate dosing of the iron supplement, defective absorption due to intestinal infestations, diets containing high levels of iron chelators, poor compliance, short supplies at the beneficiary level, and lack of effective health education (2). Iron sucrose has minimal side-effects, and because it is administered intravenously (IV), it overcomes the problems with oral iron supplementation, including problems of compliance. Unlike intravenous dextran iron, anaphylactic reactions are very rare with iron sucrose. Blood transfusion is limited to those cases with severe anemia at term, established or incipient cardiac failure or infections. It carries the risk of transmission of blood borne infections, besides mismatched transfusion reactions.