Intravenous Iron sucrose compared to oral Iron in correction of Iron deficiency Anemia during pregnancy

Volume : VII, Issue : VI, June - 2018

Dr. V. Mary Snygdha, Dr. R. Indira Priyadarshini

AIMS AND OBJECTIVES: 1. To compare the efficacy of intravenous sucrose over oral iron in treatment of iron

de􀃶ciency anemia.

2. To study the adverse effects of intravenous iron sucrose over oral iron.

MATERIALS AND METHODS: The study was conducted over a period of 2 years from 2015 January to 2016 December in the antenatal

clinic of Government General Hospital, ACSR Medical college Nellore .

This is a prospective comparative study involving two groups of patients. 100 women around 26 weeks of Gestational age were selected in

each group. I choose mild to moderate anaemia in 2nd trimester since it may worsen severe anemia in 3rd trimester and its associated

complications.

SUMMARY: In my study I studied 200 women with mild to moderate iron de􀃶ciency anemia with> Hb 7gm/dl around 24 weeks of gestation

of which 100 women were given intravenous iron sucrose as per the formula weight at 􀃶rst visit (Kgs) (11-Hb%) X 2.4+500mg). The patients

were given 200 mg of elemental iron in 100ml of normal saline on alternate days. No testing dose was given. For all the women in the study

group deworming was done by albendazole 400mg stat and iron de􀃶ciency was con􀃶rmed by peripheral smear. Hb and PCV are calculated.

Oral group received 333mg (100mg elemental iron) twice a day for 100 days. Hb% and PCV were calculated at the time of recruitment.

The mean Hb and PCV level in the intravenous group before treatment is 8.026g/dL and 23.58% and after treatment it was 10.84g/dL and

31.96% after two weeks respectively after administration of 766.8gms of elemental iron. There is a signi􀃶cant rise in the Hb % level before

and after treatment (p<0.001) was calculated by ‘Paired t test‘. The man Hb and PCV level in the oral group before treatment is 8.39g/dL and

24.9% and after treatment it was 9.76g/dL and 28.01% after 100days respectively. There is also a rise in the Hb level in the oral iron group but

the mean rise in the Hb level is signi􀃶cantly higher in the Intravenous group than oral group( p<0.001) calculated by ‘student t test‘.

CONCLUSION: Intra venous route is the preferred mode of improving Hb signi􀃶cantly in mild to moderate iron de􀃶ciency anemia in

pregnancy.

The iron sucrose complex has minimal side effects and no test dose is required and can be given on a OP basis. This drug can be used where

rare blood groups like negative blood group and are safely administered where the blood is not available in the blood bank. Patient has

better compliance and less side effects.

In oral iron therapy compliance is less and gastro intestinal side effects are more and duration of therapy is more than 3months. In these

3months patients can be develop both maternal and fetal complications of anemia. Further in India iron absorption is very low because of

worm infestations and many other reasons, mentioned early. Intravenous iron absorption is high because of its low molecular weight.

I conclude that Iron sucrose complex is more effective in improving the Hb levels with minimal side effects in a shorter period. This makes it

convenient and effective in pregnant iron de􀃶cient women, who are unable to obtain an adequate amount of iron rapidly by oral route.