Study of outcome of the treatment with intravenous iron sucrose in moderately anaemic pregnant women

Background: Moderate anaemia seen in about 15-20% of pregnant women. Iron sucrose complex which is used intravenously for the correction of Iron deficiency anaemia. The drug has been able to raise the haemoglobin to satisfactory level when used in moderately anaemic iron deficient pregnant women. The objective of this study was to study the improvement of Hb% after treatment with intravenous Iron sucrose complex in moderately anaemic pregnant women belonging to 24-32 weeks of gestational age.Methods: 50 antenatal patients between gestational age 24-32 weeks with hemoglobin between 8-9.5g/dl were selected and included in this study. They were subjected to blood hemoglobin estimation, hematocrit and peripheral smear study. In each infusion, the maximum total dose administered was 200 mg iron sucrose in 100 ml of normal saline, slow IV infused over 30 minutes. Monitoring was done throughout the infusion to observe for any side effects.Results: Mean hemoglobin among the 50 patients before starting the therapy was 8.172g/dl and the mean hemoglobin at the end of one month of completing the therapy was 11.066g/dl. The rise in mean hemoglobin i.e. the difference in the mean hemoglobin before and after treatment was 2.894g/dl. The p value is 0.0001 which is statistically significant. The mean hematocrit of the 50 patients studied before starting the treatment was 26.772% with a standard deviation of 1.914. The mean hematocrit after completing the therapy was 33.872% with a standard deviation of 1.321. The difference in the mean hematocrit was 7.100% with a p value of 0.0001 which is statistically significant.Conclusions: Intravenous iron sucrose complex is well tolerated and highly efficacious in improving hemoglobin, hematocrit in the treatment of iron deficiency anaemia in antenatal women.

Optimization of the conditions for the synthetic preparation of iron sucrose complex by response surface methodology / 国际药学研究杂志

Objective To optimize the conditions for the synthetic process of iron sucrose complex (ISC), via the investigation of the effects of reaction temperature (X1), reaction time (X2), amount of alkali (X3), and amount of sucrose (X4) on the relative molecular mass of the ISC product. Methods According to the experimental results for the single factor, the conditions dealing with the X1, X2, X3, and X4 parameters for the preparation of ISC were optimized by the Box-Behnker design combined with the response surface methodology using the weight average relative molecular mass of ISC as an indicator, and analyzed with gel permeation chromatography. Results The reaction temperature and the amount of alkali had a significant effect on the weight average relative molecular mass of ISC. The influence of the four factors in the descending order was as follows:X3＞X1＞X2＞X4. In the designed experimental conditions, theresponsevaluedecreasedwiththeincreaseofbothreactiontemperaturesandalkaliamounts. Conclusion Theresponse surface methodology could provide the relationship between the response values and variables via the minimum number experiments to obtain the optimized conditions for the preparation of ISCs.

Evaluation of effectiveness of intravenous iron sucrose in antenatal patients of iron deficiency anemia.

Background: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy. Prophylactic oral iron is recommended during pregnancy to meet the increased requirement of iron. In India, more than 50% women become pregnant with low baseline haemoglobin level resulting in high incidence of moderate to severe anaemia in pregnancy where oral iron therapy cannot meet the requirement. This study was undertaken for critical evaluation of iron sucrose in terms of efficacy, safety, and feasibility along with any reduction in blood transfusion rate. Aims & Objective: To evaluate the efficacy of intravenous Iron sucrose in antenatal patients with Iron deficiency anaemia and to study the side effects of intra venous Iron sucrose. Material and Methods: This prospective study was conducted from Nov 2012 to June 2013 at VS General Hospital, Ahmedabad. 60 antenatal patients found to have anaemia having Hb level < 9 gm% were admitted and given intravenous iron sucrose therapy 100mg alternate day after calculating the dose of the iron requirement. Results: In patients having moderate anaemia (Hb 7-9 gm%), the rise in Hb found to be 2.17 ± 0.45 gm% from pre-treatment Hb of 7.88 ± 0.58 gm% to 9.9 ± 0.53 gm%. In patients with severe anaemia (Hb < 7 gm%), the rise in Hb was observed up to 2.73 ± 0.51 (SD) gm% after 1 month of iron sucrose treatment. No major side effects or anaphylactic reactions were noted during the study period. Conclusion: Parenterally administered iron sucrose elevates Hb and restores iron stores earlier and also that intravenous iron administration has led to the reduction in the rate of blood transfusion rate.

Intravenous iron sucrose therapy for moderate to severe anaemia in pregnancy.

Background & objectives: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy. Prophylactic oral iron is recommended during pregnancy to meet the increased requirement. In India, women become pregnant with low baseline haemoglobin level resulting in high incidence of moderate to severe anaemia in pregnancy where oral iron therapy cannot meet the requirement. Pregnant women with moderate anaemia are to be treated with parentral iron therapy. This study was undertaken to evaluate the response and effect of intravenous iron sucrose complex (ISC) given to pregnant women with IDA. Methods: A prospective study was conducted (June 2009 to June 2011) in the department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. One hundred pregnant women with haemoglobin between 5-9 g% with diagnosed iron deficiency attending antenatal clinic were given intravenous iron sucrose complex in a dose of 200 mg twice weekly schedule after calculating the dose requirement. Results: The mean haemoglobin raised from 7.63 ± 0.61 to 11.20 ± 0.73 g% (P<0.001) after eight wk of therapy. There was significant rise in serum ferritin levels (from 11.2 ± 4.7 to 69 ± 23.1 μg/l) (P<0.001). Reticulocyte count increased significantly after two wk of starting therapy (from 1.5 ± 0.6 to 4.6±0.8%).Other parameters including serum iron levels and red cell indices were also improved significantly. Only one woman was lost to follow up. No major side effects or anaphylactic reactions were noted during study period. Interpretation & conclusions: Parentral iron therapy was effective in increasing haemoglobin, serum ferritin and other haematological parameters in pregnant women with moderate anaemia. Intravenous iron sucrose can be used in hospital settings and tertiary urban hospitals where it can replace intramuscular therapy due to injection related side effects. Further, long-term comparative studies are required to recommend its use at peripheral level.

Safety and efficacy of parenteral iron sucrose complex therapy in iron deficiency anemia in antenatal and postnatal women.

Background: Iron deficiency anaemia (IDA) is one of the common medical disorders in pregnancy in the developing world, which affect both the mother and the newborn and subsequent child and later adult. Aims & Objective: This study is undertaken to evaluate the safety and efficacy of parenteral iron sucrose complex therapy in iron deficiency anaemia in antenatal and postnatal women. Material and Methods: 110 consecutive pregnant women between 16-36 weeks of gestation and postnatal women, diagnosed as cases of Iron deficiency anaemia with Hb level 5-8 gm%, who were seen from May 2009 to April 2011 in our Hospital, were included in the study. All the patients received Iron Sucrose Complex in infusion form with the aim to correct the iron deficiency as well as to replenish the iron stores. The aim was to bring her Hb level to 10gm%. Result were analyzed in terms of the safety& efficacy, Results: Intravenous iron sucrose is effective in achieving target Hb of 10g/dl in 80% of patients. It shows that of IV iron sucrose significantly (P<0.001) increase Hb levels within 4 weeks. There were no major adverse reactions. All women stated that they found the treatment acceptable to them. Iron Sucrose Injection is relatively safe and well tolerated. Conclusion: Iron sucrose (intravenous) therapy is safe, more effective and well tolerated in the treatment of iron deficiency anaemia during pregnancy. Overall, iron sucrose appears to be a treatment of choice with no serious side effect indicated in the rapid correction of anaemia in pregnancy or restoring maternal iron stores, especially because the total dose can be administered over a shorter period of time. If used in time, this treatment will certainly help to reduce the risk of maternal and foetal complications as well as it also reduce the risk of blood transfusion during peripartum period.

Intravenous Iron-Sucrose Complex for Treatment of Iron Deficiency Anaemia in Pregnancy - Experience in an Obstetric Day Care Clinic in a Tertiary Hospital

A cross-sectional study was undertaken to evaluate if outpatient administration of in-travenous iron sucrose complex (Venofer) was a sensible option in treating iron defi-ciency anaemia during pregnancy and puerperium. A total of 120 patients with iron deficiency anaemia were recruited from the Obstetric Day Care Clinic at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) over 18 months from March 2003 to August 2004. The main outcome measures were haemoglobin increment, patients’ compliance, adverse effects and saving from hospitalization fees. The pre-treatment haemoglobin (Hb) level was 8.5+0.85g/dl for the antenatal patient and 7.6+0.80 g/dl in the post-partum group. The mean post-treatment haemoglobin increment at day four-teenth was 3.52+0.75g/dl. One patient developed skin rash while another had low-grade pyrexia. Seven patients experienced mild metallic taste. There were no serious side effects or anaphylactic reactions. Ten patients (8.3%) did not complete their ther-apy - eight delivered before completion of treatment; another two defaulted following delivery. The average number of Venofer used was seven ampoules i.e. 700mg per person, most of them required three sessions to complete the course. Outpatient treatment allows each patient to save hospitalization fees of RM45 per day, which to-talled up to RM135 for a 3-days ward stay. An estimation of RM16,200 hospitalization fees for the 120 patients was avoided during the study period. In conclusion, outpatient treatment of anaemia in pregnancy and post-partum period using Venofer was safe and feasible, with high patient compliant and cost-savings from hospitalization fees.