Pınar KADİROĞULLARI, Kerem Doğa SEÇKİN, Olgu İçten BAFALİ, İbrahim POLAT

Postpartum dönemde demir eksikliği anemisi olan hastalarda intravenöz ve oral demir tedavisinin karşılaştırması

Amaç : Kadınlarda postpartum demir eksikliği anemisi oldukça yaygındır. Çoğu kadın oral veya intravenöz (iv) demir ile ya da kan transfüzyonu ile tedavi edilir. Bu çalışmanın amacı, intravenöz ferrik karboksimaltozun postpartum anemisi olan kadınlarda ferröz sülfatla karşılaştırıldığında etkinliğini, güvenilirliğini ve tolere edilebilirliğini değerlendirmektir.Gereç ve Yöntemler: Çalışmamız postpartum 1.günde hemoglobin değeri 8 ile 10 g/dl arasında olan hastalardan, hastanede yatışı süresince iv demir tedavisi verilen ve taburculuk sonrası oral demir tedavisi alan hastaların dosyalarının incelenmesi ile oluşturuldu. 1.grubu oluşturan hastalar; postpartum 1.günde 15mg/kg den maksimum 1000 mg iv ferrik karboksimaltoz tedavisi alan (n:100), 2.grubu oluşturan hastalar ise postpartum taburculuk ile beraber oral ferroz sulfat (100 mg) / 2x1 den 6 hafta boyunca tedavisi düzenlenen hastalardı (n:100). Her iki grupta yer alan hastaların sistem üzerinden bilgileri ve tetkik sonuçları incelendi ve postpartum 1.gün, 14.gün ve 40.gün hemoglobin, hematokrit ve ferritin düzeyleri kaydedildi.Bulgular: Bu hastalardan 1. grubun yaş ortalaması 29.8, 2. grubun yaş ortalaması 29.0 olarak saptandı. Gruplar arasında gravida ve parite sayıları, doğum şekilleri ve tedavi öncesi bakılan hemoglobin (Hb) ve hematokrit (Htc) değerleri arasında fark yoktu. Tedavi sonrası 1. Gün bakılan Hb ve Htc değerleri iv demir tedavisi alan 1.grupta, oral demir tedavisi alan 2.gruba göre anlamlı derecede yüksekti (p<0.005). İv demir tedavisinin Hb ve Htc değerlerini hızlı artırdığı saptandı. 14. Gün bakılan Hb, Htc ve ferritin değerleri ortalaması 1. grupta anlamlı olarak daha yüksekti (p<0.005). Gruplar arasında 40. Gün bakılan parametrelerde anlamlı fark görülmedi. Tartışma : Postpartum demir eksikliği anemisinin tedavisinde intravenöz ferrik karboksimaltoz güvenli ve iyi tolere edilebilmektedir. İntravenöz demir tedavisinin postpartum anemisi olan kadınlarda hemoglobin seviyesini oral ferröz sülfattan daha hızlı arttırdığı gösterilmiştir. Ayrıca demir depolarını daha hızlı bir şekilde doldurduğu görülmüştür.

Anahtar Kelimeler:

Demir Karboksimaltoz, Demir Sülfat, Postpartum anemi, İntravenöz tedavi, Oral tedavi

Comparison of intravenous and oral iron treatment in patients with iron deficiency anemia in postpartum period

Aim: The aim of the study is to evaluate the efficacy, safety and tolerability of intravenous ferric carboxymaltose in women with postpartum anemia compared to oral ferrous sulfate.Material and Methods: Our study was created by reviewing the records from patients who had hemoglobin levels between 8 and 10 g/dl on postpartum first day, and those who received intravenous iron treatment during hospitalization and who received oral iron treatment after discharge. Patients in group 1; In the postpartum first day, patients who were treated with ferric carboxymaltose treatment at a rate of 15 mg / kg maximum 1000 mg and patients in the second group were treated with oral ferrous sulphate (100 mg) 2x1 for 6 weeks after postpartum discharge. The data of the patients in both groups and their results were analyzed and hemoglobin, hematocrit and ferritin levels were recorded on the postpartum 1st, 14th and 40th day. Results: The mean age of these patients was 29.8 ± 7.1 in group 1, and 29.0 ± 5.3 in group 2, respectively. There was no significant difference between the groups in terms of gravidity, parity numbers, delivery patterns and Hb and Htc levels before the treatment. The Hb and Htc levels on first day after treatment were significantly higher in the group 1 received iv iron treatment compared to the group 2 received oral iron therapy (p <0.005). Iv iron treatment was found to increase Hb and Htc levels rapidly. The mean of Hb, Htc and ferritin levels on 14th day was significantly higher in group 1 (p <0.005). No significant difference was observed between the groups at the 40th day. Discussion: Intravenous ferric carboxymaltose is safe and well tolerated in the treatment of postpartum iron deficiency anemia. Intravenous iron therapy increases the hemoglobin levels in women with postpartum anemia faster than oral ferrous sulphate. It also fills iron store more quickly.

Keywords:

Ferric carboxymaltose, Ferrous sulfate, Intravenous treatment, Oral treatment, Postpartum iron deficiency anemia,

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