Anemia during pregnancy and treatment with intravenous iron: review of the literature

Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Beer-Sheva, Israel.
European Journal of Obstetrics & Gynecology and Reproductive Biology (Impact Factor: 1.63). 10/2003; 110(1):2-7. DOI: 10.1016/S0301-2115(03)00113-1
Source: PubMed

ABSTRACT Anemia, the decrease of the hemoglobin concentration with a consequent decrease in the hematocrit level, is a common disorder complicating pregnancies and is mostly due to iron deficiency. The increase of iron requirements, plasma volume, and the poor intake of iron constitute the principal causes of this deficiency. The present review summarizes the current literature regarding anemia during pregnancy and the parenteral iron therapy options.

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    ABSTRACT: ABSTRACT Objective: To determine the efficacy and safety of Total Dose Infusion (TDI) of low molecular weight iron dextran for the treatment of iron deficiency anemia compared to oral iron replacement during pregnancy through improvement in hemoglobin (Hb) after intervention. Study Design: Non-randomized control trial. Place and Duration of Study: Section of Gynaecology and Obstetrics, Shifa International Hospital and Shifa Community Health Centre, Islamabad during January 2005 to January 2006. Patients and Methods: A group of 100 pregnant women with gestational age greater than 12 weeks with confirmed diagnosis of iron deficiency anemia attending the antenatal clinics were enrolled in this study. Total dose iron infusion of low molecular iron dextran was given to these patients after calculating iron deficit, in a monitored in-patient setting. Control comprised of a second group of 50 pregnant females matched for age, parity and baseline hemoglobin, tolerant to oral iron supplementation (ferrous sulphate 200 mg three times a day) attending the antenatal clinics during the same period. Post-treatment hemoglobin levels of study group as well as the oral control group were determined between 3 to 4 weeks. Results: In the intervention group, mean pre-infusion hemoglobin level was 8.57 ± 0.9 gm/dl (range 5-10.5 gm/dl) and mean post-infusion Hb was 11.0 ± 1.1 (range 8.4-14.3 gm/dl). In control group, mean pre-oral intake Hb level was 9.5 ± 0.9gm/dl (range 7-10.5 gm/dl) and mean post-oral intake Hb was 10.2 ± 1.2 gm/dl (range 6.4-12.8 gm/dl). Mean increase of Hb in intervention group was 2.43 gm/dl (95% CI 2.4 - 3.8) and for controls it was 0.7 gm/dl (95% CI 0.6-2.3). Flushing and palpitations were observed in 4% of interventional group patients and none in the control group. No significant adverse reactions were observed in either group. Conclusion: We conclude that the total parenteral iron replacement with low molecular weight iron dextran is an effective and safe method for the treatment of iron deficiency anemia in a selected group of pregnant women. Key words: Iron dextran. Anemia. Pregnancy.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 01/2008; 18(7):424-427. · 0.32 Impact Factor
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    ABSTRACT: Anemia is a common problem in obstetrics and perinatal care. Any hemoglobin (Hb) below 10.5 g/dl can be regarded as true anemia regardless of gestational age. Main cause of anemia in obstetrics is iron deficiency, which has a worldwide prevalence between estimated 20 and 80% of especially female population. Stages of iron deficiency are depletion of iron stores, iron-deficient erythropoiesis without anemia and iron-deficiency anemia, the most pronounced form of iron deficiency. Pregnancy anemia can be aggravated by various conditions such as uterine or placental bleedings, gastrointestinal bleedings and peripartum blood loss. Beside the general consequences of anemia, there are specific risks during pregnancy for the mother and the fetus such as intrauterine growth retardation, prematurity, feto-placental miss-ratio and higher risk for peripartum blood transfusion. Beside the importance of prophylaxis of iron deficiency, main therapy options for the treatment of pregnancy anemia are oral iron and intravenous iron preparations.
    Expert Review of Obstetrics &amp Gynecology 01/2014; 8(6). DOI:10.1586/17474108.2013.842683
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    ABSTRACT: Abstract Aim: To examine how complex and irregular fetal heart rate (FHR) dynamics differ between fetuses of normal pregnancies and those of pregnancies complicated by maternal anemia (MA), and to place this in the context of high-risk pregnancies. Methods: Our study population consisted of 97 pregnant women affected by MA, 118 affected by pregnancy-induced hypertension (PIH), 88 affected by gestational diabetes mellitus (GDM), 53 with preterm premature rupture of membranes (pPROM), and 356 normal pregnancies as controls. We calculated approximate entropy (ApEn), sample entropy (SampEn), and correlation dimension (CD) to quantify irregularity and the chaotic dynamics of each FHR time series. Results: The ApEn in the fetuses of the MA and PIH groups was significantly lower than that of the normal controls (P<0.05). The SampEn was significantly lower in the high-risk groups, except for the pPROM group, than in the normal controls (P<0.05). The CD in the PIH and severe MA groups was significantly lower than that of the normal controls (P<0.05, respectively). In the MA group, the dynamic indices showed a highly significant positive correlation with hemoglobin (Hb) levels (P<0.0001). Conclusion: The decreased complexity and/or irregularity in the FHR from pregnancies with MA may reflect abnormalities in the complex, integrated cardiovascular control. The irregularity and complexity of the FHR increased together with Hb levels in pregnancies with MA. Our data suggest that the integrity of the nervous system in the fetuses compromised by severe MA might result directly in adverse outcomes.
    Journal of Perinatal Medicine 08/2014; DOI:10.1515/jpm-2014-0104 · 1.43 Impact Factor