Aşkın Evren GÜLER, Zeliha Ciğdem Demirel GÜLER, Melahat ATASEVER, Erhan AKTÜRK

Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia

Objective: In our study, we aimed to compare the hematological efficacy of intravenous and oral forms of iron treatment in clinically stable patients with moderate postpartum anemia. Material and Method: One hundred and eighty postpartum cases, who had pre-discharge hemoglobin evaluation levels between 8-9.5 g/dl, were allocated into two groups. The 1st group was treated with oral fe +2 (n = 127, 70.6%), and the other group was treated with intra venous ferric carboxymaltose (n = 53, % 29.4). Group 1 received oral iron treatment for aproximately 8 weeks. Also in Group 2, intra venous ferric carboxymaltose iron replacement was performed twice with 1 week intervals. Late postpartum (8 weeks after delivery) hemoglobin levels were collected and recorded. Findings: Difference between the group 1 and group 2 in terms of late postpartum maternal haemoglobin levels was found statistically significant (respectively, 10,52±1,26 g/dl vs 11,82±1,06 g/dl, P value 0,021). After intravenous treatment, increase rate of hemoglobin in group 2 was found statistically significant when comparing with of in group 2. (1,51±0,72 g/dl vs 2,90±0,46 g/dl, P value ˂0,01 ). Conclusion: Although clinical evaluations and stability of anemic postpartum cases are part of our overall treatment and patient follow-up approaches, moderate and deeper anemic cases should be treated with 3rd generation intravenous iron forms for rapid hematologic improvement. Amaç: Çalışmamızda, orta düzey postpartum anemisi olan ve klinik olarak stabil olan hastalarda intravenöz ve oral demir tedavi seçeneklerinin hematolojik etkinliğini karşılaştırmayı amaçladık. Materyal ve Metod: Doğum sonrası taburcu olmadan hemen önce hemoglobin değerlerini 8-9.5 gr/dl olan 180 postpartum olgu iki gruba ayrıldı. 1. grup oral fe +2 (n = 127, %70.6), diğer grup ise intravenöz ferrik karboksmaltoz (n = 53, %29.4) ile tedavi edildi. Grup 1 oral demir tedavisi yaklaşık 8 hafta aldı. Grup 2'ye 1 hafta ara ile iki kez intravenöz ferrik karboksmaltoz replasmanı yapıldı. Geç postpartum (doğumdan 8 hafta sonra) hemoglobin düzeyleri toplandı ve kaydedildi. Bulgular: Postpartum maternal hemoglobin seviyeleri açısından grup 1 ve grup 2 arasındaki fark istatistiksel olarak anlamlı bulunmuştur (sırasıyla, 10,52±1,26 g/dl, 11,82±1,06 g/dl, P değeri 0,021). Grup 2’ de intravenöz demir tedavisi sonrası hb seviyelerinde artış oranı grup 1’le karşılaştırıldığında anlamlı olarak yüksek bulunmuştur. (sırasıyla, 1,51±0,72 g/dl, 2,90±0,46 g/dl, P değeri ˂0,01 ). Sonuç: Anemik postpartum vakaların klinik değerlendirmeleri genel tedavi ve hasta takip yaklaşımlarımızın bir parçası olsada, orta ve derin anemik olgular hızlı hematolojik iyileşme için 3. jenerasyon intravenöz demir formları ile tedavi edilmelidir.

Anahtar Kelimeler:

postpartum anemia, iron deficiency, iron preparations

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