Comparison for Effects of Intravenous versus Oral Iron Therapy for Postpartum Anemia

Objectives: The aim of our study was to compare the effects of intravenous ferrous sucrose versus oral ferrous sulphate on postpartum iron deficiency anaemia. Material and methods: This prospective randomized study was conducted in Obstetrics and Gynaecology Department of Alkhidmat Teaching Hospital Mansoorah Lahore and in the Obstetrics and Gynaecology Department of Akhtar Saeed Trust Hospital in 2009. The study included 80 postpartum patients. The inclusion criteria was Hs<9 gm/dl and serum ferritin of <15 μg/l at 24-48 hours postdelivery. The exclusion criteria was intolerance to iron derivatives, peripartum blood transfusion or a history of asthma, thromboembolism, seizure, alcohol, drug abuse, renal or hepatic dysfunction. Women were divided into two groups consisting of forty patients in each group by randomization. The group I received 2 doses of intravenous ferrous sucrose 200 mg given in day 2 and 4 as an infusion in 100 ml of 0.9% sodium chloride for more than 30 minutes. In group II patients were advised to take 200 mg of ferrous sulphate twice daily together with meals for 6 weeks. Blood samples were measured on day 0, 7, 14 and at 40 days for Haemoglobin levels, hematocrit, red-cell indices, serum ferritin and serum iron levels were measured. All analysis was conducted using SPSS for Windows, version 10.0. Results: On day 7 in group 1, haemoglobin rises from 8.4 to 11 g/dl whereas in group II, Hb rises from 7.8 to 8.3 g/dl. The rise in haemoglobin level is rapid in intravenous group and in the oral group it is a gradual rise but at 40 days the result showed no significant difference in between the two groups. As far as the iron stores are concerned, serum ferritin in group I rose rapidly and remained at higher level where in group II, rise in serum ferritin is comparatively less than the intravenous group. Similarly the results are same in the case of serum iron. Conclusion: Intravenous iron sucrose is efficacious and a successful method for raising the level of iron stores as compared to oral iron supplements.