Vivekanand A,^a Kanikireddy S^b

^aProfessor, Department of Obstetrics and Gynecology, Prathima Institute of Medical Sciences, Karimnagar , Andhra Pradesh, India. ^b Ex- Postgraduate student, Department of Obstetrics and Gynecology, Kakatiya Medical College, Warangal.

Address for correspondence : Dr. Achanta Vivekanand, Professor, Department of Obstetrics and Gynecology Prathima Institute of Medical Sciences, Karimnagar , Andhra Pradesh, India.

Email: achanta.vivekanand@gmail.com

Introduction : Iron deficiency anaemia remains the most common medical disorder in pregnancy in the developing world, with the burden of disease impacting on both the mother and the new born. Packed cells\blood transfusions are associated with complications like both immune and non-immune mediated reactions and blood borne diseases. The safety of sucrose has been demonstrated in previous studies.

Materials and Methods : A prospective, comparative study was conducted in the Department of Obstetrics and Gynaecology, Kakatiya Medical College, Warangal during August 2010 to August 2012. All antenatal women were screened for anaemia and those presenting with moderate to severe anaemia between gestational age of 16-34 weeks were included in the study. These women were randomly selected to study and control groups where for the study group Intravenous Iron Sucrose was given and for control group, packed cell transfusion was given. A detailed history, clinical examination, obstetric examination and investigations were done for these antenatal women and an informed consent was taken.

Results : On an average 80% were in the age group of 15-24 years in both groups. In iron sucrose group, mean Haemoglobin % at baseline 7.1±0.8g/dl, after1 week 7.9±0.6, after 4 weeks 11±0.5g/dl and at delivery 11.7±0.6 g/dl. Where as in packed cell group, baseline Hb% was 7.0±0.8g/dl, after 1 week 10.2±0.5%g/dl, after 4 weeks 10.3±0.5 g/dl and at delivery 10.2±0.4% g/dl. The mean haematocrit values in iron sucrose group at baseline 20.9±2.5%, after 1 week 25.3±2.2% and 4 weeks 33.6±2.0%. And in packed cell group at baseline 20.8±2.3%, after 1 week 30.0±1.9% and after 4 weeks 30.2±2.0%. The mean ferritin values in Iron sucrose group at baseline and after 4 weeks are 8.9±1.7μg/L and 89.8±6.7μg/L respectively where as in packed cell group, at baseline 8.7±1.8μg/dl and at 4 weeks, 40.1±5.4μg/L. In both groups, with each intervention the improvement in Hb%, haematocrit and ferritin values were statistically significant.

Conclusion : Parental Iron Sucrose is a safe, nontoxic alternative to packed cell transfusion in the management of moderate to severe anaemia complicating pregnancy. Parental iron sucrose therapy has a sustained rise of haemoglobin and haematocrit which persists even after the time of delivery and should be an integral part of management for the patients of moderate to severe anaemia.

Keywords : Parenteral Iron Sucrose, packed cell transfusion, anaemia, pregnancy