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. Amac: Calismamizda, orta duzey postpartum anemisi olan ve klinik olarak stabil olan hastalarda intravenoz ve oral demir tedavi seceneklerinin hematolojik etkinligini karsilastirmayi amacladik. Materyal ve Metod: Dogum sonrasi taburcu olmadan hemen once hemoglobin degerlerini 8-9.5 gr/dl olan 180 postpartum olgu iki gruba ayrildi. 1. grup oral fe +2 (n = 127, %70.6), diger grup ise intravenoz ferrik karboksmaltoz (n = 53, %29.4) ile tedavi edildi. Grup 1 oral demir tedavisi yaklasik 8 hafta aldi. Grup 2'ye 1 hafta ara ile iki kez intravenoz ferrik karboksmaltoz replasmani yapildi. Gec postpartum (dogumdan 8 hafta sonra) hemoglobin duzeyleri toplandi ve kaydedildi. Bulgular: Postpartum maternal hemoglobin seviyeleri acisindan grup 1 ve grup 2 arasindaki fark istatistiksel olarak anlamli bulunmustur (sirasiyla, 10,52±1,26 g/dl, 11,82±1,06 g/dl, P degeri 0,021). Grup 2’ de intravenoz demir tedavisi sonrasi hb seviyelerinde artis orani grup 1’le karsilastirildiginda anlamli olarak yuksek bulunmustur. (sirasiyla, 1,51±0,72 g/dl, 2,90±0,46 g/dl, P degeri ˂0,01 ). Sonuc: Anemik postpartum vakalarin klinik degerlendirmeleri genel tedavi ve hasta takip yaklasimlarimizin bir parcasi olsada, orta ve derin anemik olgular hizli hematolojik iyilesme icin 3. jenerasyon intravenoz demir formlari ile tedavi edilmelidir.