Imferon Drip in a Unit

Abstract

IN 1963, I was posted as Regimental Medical Officer to the Training Depot Brigade of Gurkhas at Sungei Patani, Kedah, Malaysia. Part of my work was the medical care of · Gurkha wives and children. There was a small Gurkha Families Hospital with 11 beds, .3 of which were for maternity cases. One of the biggest problems in dealing with Gurkha families is the anaemia in pregnant women. During my time at the Depot Brigade ·of Gurkhas, I saw 170 pregnant women and the average haemoglobin at first attendance, at the ante-natal clinic was 55-60 per cent. On first attending the ante-natal clinic, iron ta:blets and vitamins were given asa routine, and the woman was also dewormed. At 28 weeks pregnancy each woman then received folic acid tabs I three times daily, in addition to iron and vitamins. Despite oral iron, the haemoglobin failed'to rise significantly. Each woman DID take her tablets because a pill parade was held each morning and a record of attendance was kept, and checked we(!kly by myself. As the Depot was 80 miles from the nearest British Military Hospital, this was a worrying problem, because it was impossible' to keep stocks of blood for transfusion · purposes in the unit. I felt it might be practical to use IMFERON by drip for the more anaemic' of these women. Unfortunately at this time, Imferon had been withdrawn from the Joint Services Medical Catalogue, but I was able to acquire a small amount initially. The usual formula for the amount of Imferon required to be given by drip is 4/5 (lOO minus present haemoglobin) =amount in millilitres e.g., if the haemoglobin was 60 per cent then the amount of Imferon required =32 millilitres. Because of the short , supply of Imferon, I reduced the factor 4/5 to 3/5. All the blood reports on the women who received the Imferon drip showed a microcytic hypochromic anaemia. Prior to the drip being commenced, 2 millilitres Imferon were given intramuscularIy, .as a test dose 5 days previously The following Table shows the response to Imferon with comments on certain of the patients.