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To Evaluate the Safety and Efficacy of Intravenous Iron Sucrose Complex Versus Oral Ferrous Sulphate in Treatment of Postpartum Iron Deficiency Anaemia  
Author(s) Name:

Asia Kanwal, Wajeha Shadab, Afshan Rehman

Address of Correspondence

Dr. Wajiha Shadab, Senior registrar Obs and Gynae deptt, IIMC, Railway Hospital Rawalpindi.

 

Abstract

Objective: To evaluate the safety and efficacy of intravenous iron sucrose complex versus oral ferrous sulphate in treatment of postpartum iron deficiency anaemia.
Study Design: Randomized controlled trial.
Place and Duration of Study: Department of Obstetrics and Gynaecology, Benazir Bhutto Hospital (BBH), Rawalpindi from September 2012 to February 2013.
Methodology: A total of 322 patients with confirmed diagnosis of postpartum iron deficiency anaemia (based on laboratory evaluation) were included in the study and divided equally into group A and B i.e. 116 patients in each group. The patients in both groups were counseled regarding treatment, dosage and side effects of intravenous iron and oral ferrous sulphate and follow up. Two groups were randomly constituted by probability systematic sampling technique. Treatment was started at 24-48 hours after delivery. Patients of Group “A” were given intravenous ferrous sucrose (Venofer) on day 2 and 4 following recruitment. The dose was calculated by using the formula: Total iron requirement=required Hb-actual Hbx250 . In Group-B women were advised to take 200 mg ferrous sulphate twice daily together with meals for six weeks from the day of recruitment. Laboratory procedures including Hb, Haematocrit, red cells indices, mean corpuscular volume, mean corpuscular Hb, and serum ferritin as an indicator of iron status on days 0, 5, 14 and 40.
Results: In Group-A Mean and standard deviation of age was 24.55+0.67 and it was 23.99+1.02 in Group-B. Parity 2-4 was common in both groups being, 101 (62.73%) in Group-A and 98 (60.87%) in Group-B. (Table II). Hb, MCV, Haematocrit and ferritin were significantly higher in Group-A on day 5, 14 and 0. (Table I and II). Regarding comparison of adverse effects of both drugs, 35 (21.74%) metallic taste, 2 (1.24%) nausea, 12(7.45%) infusion site burning and no complications in 112(69.57%) in Group-A while 10(6.21%) cases had metallic taste, 12(7.45%) nausea, 5(3.11%) constipation, 9(5.59%) colicky pain, 9(5.59%) diarrhoea and 98(60.87%) had no complications in Group-B. (Table III)
Conclusion: Iron sucrose compared to oral iron administration is more efficient in treating postpartum anaemia without any significant adverse effects.
Key Words: Post partum anaemia, management, intravenous iron sucrose complex, oral ferrous sulphate.

 

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