Iron Deficiency Anemia in Pregnancy: Intravenous Iron Sucrose versus Oral Iron Sulfate

Abstract

Introduction: Injectable iron sucrose and oral ferrous sulfate both are used for the correction of anaemia in second and third trimester of pregnancy. But injectable iron is supposed to be more effective than oral iron, as it needs less time for correction of anaemia and efficacy is more. Oral iron is cost effective but more time consuming. The objective of the study was to compare the safety of intravenous iron sucrose complex in the treatment of iron deficiency anemia in third trimester of pregnancy. To compare the efficacy of intravenous iron with oral iron. Method: A randomised controlled trial was conducted in which pregnant women with iron deficiency were sequentially selected from the pregnant women attended antenatal clinic of OPD of Institute of Child and Maternal Health (ICMH) and assigned either to injectable or to oral ferrous sulfate by random number table. Each study patient was given the total calculated amount of injectable iron sucrose {Hb deficit (gm/l) × body weight (kg) × 0.24+ storage iron mg } in divided dose 200 mg in 200 ml normal saline intravenously over 1 hour every alternate day . Each patient of the control group was given ferrous sulfate 200mg orally three times a day for 4 weeks. Pregnant women follow up at 4 weeks and 8 weeks after get treatment by oral and injectable iron. During follow up monitored for adverse effects, clinical and laboratory response and haemoglobin percentage were observed. Result: There were 75 patients in injectable group and 75 patients in oral group. Injectable group achieved a significantly higher Hb level (11.49 ± 0.39) than oral group Hb level (10.39 ± 0.75) after 8 weeks of treatment. Injectable group showed no major side effects, only two patient had complains .One patient complain of epigastic pain and one patient complain of tachycardia while in oral group complain of nausea and vomiting, epigastic pain, constipation, allergic reaction was found in 42.0%, 39.3%,35.7% and 3.6% respectively. Conclusion: Iron sucrose complex appears to be a safe and effective in the treatment of iron deficiency anemia. Key word: Iron deficiency anemia in pregnancy, Injectable iron, oral iron. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1): 40-44