Comparison of Efficacy of Treatment with Oral Ferrous Sulfate or Intravenous Iron Sucrose in the Treatment of Mild to Moderate Iron Deficiency Anemia in Pregnancy
Georgy J Eralil
Anaemia, Ferrous sulphate, Iron deficiency, Iron sucrose
Citation Information :
Eralil GJ. Comparison of Efficacy of Treatment with Oral Ferrous Sulfate or Intravenous Iron Sucrose in the Treatment of Mild to Moderate Iron Deficiency Anemia in Pregnancy. J Postgrad Med Edu Res 2018; 52 (4):167-170.
Objective: To compare the effect of treatment with either oral ferrous sulphate or intravenous iron sucrose (IVIS) on hematological parameters of women with iron deficiency anemia in pregnancy.
Methods: This prospective randomized study was interventional, conducted from January 2016 to January 2017 in Department of Obstetrics and Gynecology Sree Narayana Institute of Medical sciences.
Pregnant women Singleton pregnancy, Hb < 11 gm in 1st and 3rd trimester Hb < 10gm in 2nd trimester, with hemoglobin level 7-10.9 g/dL ferritin levels less than < 13 microgram/L and peripheral smear hypochromic microcytic anemia were enrolled into intravenous iron and oral iron groups. After detailed history and examination, laboratory investigations performed were hemoglobin, mean corpuscular volume (MCV), serum ferritin and peripheral smear. The dose for IVIS dose is calculated by ganzoni equation. Total iron deficit (mg) = body weight (kg) × [Target Hb (g/L)-actual Hb (g/L)] × 0.24 + depot iron (mg). A maximum IVIS is given as 200 mg in 100 ml normal saline as infusion over 15 to 30 minutes The remaining doses were given on alternate days. Infusions were given as outpatient basis in labor room with facilities for acute emergency care. Oral iron group received ferrous sulphate supplementation.
Results: Target hemoglobin of 11 g/dL was attained by 66 %. Hemoglobin done just prior to delivery showed no statistically significant difference (p value = 0.080) [OI group 11.83 (+11.98) g/dL vs. IVIS group 16.19 (+ 11.35) g/dL]. There was significant increase in serum ferritin levels with IVIS infusion There was no significant difference in antepartum or postpartum hemorrhage, infection, preterm labor, between the two groups.
Conclusion: The study concludes that oral iron increases hemoglobin comparably with IVIS. The replenishment of iron stores was good with IVIS compared with oral ferrous sulphate.
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