Anaemia in pregnancy: prevalence and treatment response to various modalities: a prospective study

Background: Anaemia seen in pregnancy are largely preventable and easily treatable if detected in time, despite this, anaemia still continues to be a common cause of maternal and perinatal morbidity and mortality in India.Methods: A prospective observational study of 200 pregnant women with anaemia was carried out from Jun 2017 to December 2018 at a Tertiary care hospital with pan India population. Patients underwent clinical examination and laboratory tests to find out the severity and type of anaemia and were treated accordingly. Iron deficiency anaemia was treated with oral or intravenous iron therapy depending upon the hemoglobin concentration. Patients were followed up after 28 days of treatment and hemoglobin estimation was done to monitor the treatment response.Results: A total 36.49% pregnant women had hemoglobin less than 10 gm%. 151 out of 200 women had serum ferritin <12 ng/ml which indicates that iron deficiency anaemia is the commonest type of anaemia in pregnancy. Overall, out of 200 patients 5.5% patients were found to have hemoglobinopathies (β thalassemia trait). After 28 days of treatment mean increase in hemoglobin was 2.40 gm% and 4.24 gm% in patients receiving oral and intravenous iron therapy respectively.Conclusions: A total 36.49% pregnant women were found to have anaemia during pregnancy and iron deficiency anaemia is the commonest type of anaemia. Therefore, there is still a need for dietary counselling and health education in the community. 5.5% patients were found to have beta thalassemia trait which was detected only after conducting hemoglobin electrophoresis. Both oral and intravenous iron therapy are effective in treatment of iron deficiency anaemia but intravenous iron therapy results in a more rapid resolution of anaemia.

Clinical profile of hypochromic microcytic anemia in Chittoor district, India

Background: Anemia is not a diagnosis by itself like fever but merely is an objective sign of the presence of disease. The correct diagnostic terminology for a child with anemia requires the detection of etiology, pathology, and pathogenesis of the anemia. To evaluate the role of therapeutic oral iron therapy as a diagnostic approach to hypochromic microcytic anemia.Methods: The present study is a retrospective study conducted at the teaching hospital, Chittoor district from September 2019 to December 2019. A total number of 350 cases of anemia were studied from both inpatient and outpatient services in the age group 2 months to 12 years. Hemogram, Hb Electrophoresis, and bone marrow study as necessary based on individual cases.Results: From the above analysis, the mean Hb% at the time of entry to study was 7.36gms%. The mean Hb% after the iron therapy was 11.8gms%. The mean increase in Hb was 4.4gms%. In this study, the average RBC count was 2.9 million cells/cumm.Conclusions: A therapeutic trial of oral iron is an appropriate initial step in the diagnostic approach of hypochromic microcytic anemia. Costly investigations like Hb electrophoresis and bone marrow study are required only in selected cases.

Compare the safety and efficacy of intravenous iron supplementation with iron sucrose to the oral supplementation with ferrous ascorbate in subjects with post-partum anemia

Background: The post-partum period is challenging enough for most new mothers. Recovering from birth, learning to parent, and taking care of her child requires lot of energy. Having anemia in postpartum period can make this process much more difficult. According to WHO, in India incidence of anemia in postnatal mother is around 58% and according to ICMR prevalence of anemia in Tamil Nadu population 76% during pregnancy. The objective of this study was to compare the efficacy of intravenous iron supplementation with Iron sucrose to the oral supplementation with ferrous ascorbate in management of patient with post-partum anemia. To study the safety and side effects of these two preparations.Methods: This was a prospective study conducted on 100 post-partum anemic women in KG Hospital  in Coimbatore, October 2012 to November 2013 with hemoglobin less than 10g/dl but more than 6g/dl within 24-48 hours of delivery ,after satisfying inclusion and exclusion criteria were included in the study.Results: Mean hemoglobin of oral group was 8.49±0.75 and mean hemoglobin of IV group was 8.43±0.76; 24 hours after delivery. After treatment, that is after 4 weeks mean hemoglobin of oral group was 10.38±0.79 and mean hemoglobin of IV group was 11.20±0.71.on comparing both groups, the increase in hemoglobin in the IV groups was significant. Reticulocyte count and other parameters increased significantly after four wks of starting therapy in IV group compare to the oral group. No major side effects or anaphylactic reactions were noted during study period.Conclusions: Intravenous iron sucrose complex is safe, convenient and effective in postpartum anemic women as compared with the oral ferrous ascorbate. Intravenous iron sucrose have shorter treatment periods, increased likelihood of compliance, a lack of gastrointestinal side effects, and rapid replenishment of iron stores, making them superior to oral ferrous ascorbate.