Effect of ferric carboxymaltose in the management of postpartum iron deficiency anemia

Background: Iron deficiency is the most common cause of anemia, around the world, with postpartum hemorrhage one of the reasons. Different treatment options are available for correction of iron deficiency, ferric carboxymaltose being the most recent

Objective: To determine the effectiveness of ferric carboxymaltose in the management of iron deficiency anemia in the postpartum period

Methodology: An experimental study was conducted at Sheikh Zayed Medical College/Hospital Rahim Yar Khan. 30 female patients, with documented iron deficiency anemia within 10 days of post partum period and with no history of renal or hepatic disease, infection, anemia due to any other causes, severe anemia requiring blood transfusion and no parenteral iron therapy in last 20 days, were included in the study. All the patient were given ferric carboxymaltose 15mg/kg body weight [max 1000mg] intravenous infusion. Pre and post therapy complete blood picture including hemoglobin and serum ferritin levels were compared after 1 week. The data was entered and analyzed in SPSS version15

Results: Significant increase in both hemoglobin and serum ferritin levels was noted in patients with mean rise being 2.4g/dl and 338.3 ng/ml in hemoglobin and serum ferritin levels, respectively. Mild rash and fever were the only adverse events noted, in only one patient, each

Conclusion: Ferric carboxymaltose appears to be a very effective drug for the treatment of iron deficiency anemia both in terms of rise in hematological indices and low adverse event profile

Fetomaternal outcome in eclamptic patients: a study in a tertiary care centre

Background: Eclampsia contributes significantly to maternal and perinatal morbidity in our country

Objective: The objective of this study was to determine the frequency of the disease, its management and outcome in tertiary care hospital; moreover the effect of introduction of modified dose of MgSo4 in the control of eclamptic seizures was also assessed

Patients and Methods: This descriptive study was carried out in Gynae unit I, Sheikh Zayed Hospital, Rahim Yar Khan from 1[st] January 2008 to 31[st] January 2009. Diagnosis was based on history and on clinical findings of hypertension, oedema, protienuria superimposed with fits. All pregnant ladies presenting with fits, oedema, proteinuria and increased blood pressure were included in this study and their history, physical findings and baseline investigations were noted. Patients with history of fits in pregnancy, during labour or in perpuerium other then eclampsia were excluded from the study. All the patients with eclampsia were treated with MgSO4 gm intravenous loading dose and 10 gm intramuscular maintenance dose. The data was entered and analyzed in SPSS version 15

Results: 12049 pregnant patients were admitted during this time period in labour room. Out of these, eclamptic patients delivered were 120 [0.99%]. Primigravida were 49%, multigravida were 51%. Regarding mode of delivery patients delivered vaginally were 80 [66.6%] and with caesarean section were 40 [33.3%]. Regarding fetal outcome fresh still births were 15 [12.5%]. Early neonatal deaths were 10 [0.8%]. Perinatal mortality rate in our study was 20.8%. Regarding maternal outcome 17 patients out of 120 eclamptic patients develop complications. 4 patients developed renal failure [3.3 %]. 2 patients develop Hellp syndrome, 4 patients shifted to ICU due to Hellp syndrome and DIC. 5 patients [4.1%] died despite of intensive care. These patients were received in critically ill condition. Almost all of these patients present with eclamptic fits were unbooked patients. In this study MgSo4 was the drug of choice to control the seizures. It helps in reducing the maternal morbidity and mortality which is comparable with the other studies in world

Conclusion: This study is in the favor of the findings that MgSo4 is superior drug in the reduction of maternal morbidity and mortality. Eclampsia occurring in unbooked patients is still one of the major cause of maternal mortality and morbidity and antenatal care will significantly reduce the incidence and improve the outcome especially in teenage nullipara who are mostly susceptible