Severe anaemia in the immediate post-partum period. Clinical practice and value of intravenous iron

Abstract Objectives Post-partum anaemia is a very frequent condition affecting 4 to 27% of women who have given birth. Our study had the dual aim of investigating daily clinical practice in dealing with severe anaemia of the immediate post-partum period and of determining the place and efficacy of treatment with intravenous iron: Venofer®. Patients and methods We conducted a retrospective study in 4292 women who gave birth from April 2001 to March 2003 in the Department of Obstetrics and Gynaecology of Belfort Regional Hospital. All patients who had a haemoglobin of less than 8 g/dL within 48 hours post-partum (217 women or 5% of women who gave birth) were included and divided into two groups depending on the availability or lack of availability of iron treatment by the intravenous route at the time when they gave birth. A range of clinical and laboratory parameters related to delivery were analysed. Results The mean haemoglobin level in the 48 hours after delivery was: 5.81 g/dL for transfused women; 6.88 g/dL for patients treated with intravenous iron and 7.43 g/dL for patients treated with oral iron. Fifteen patients were transfused in the year prior to the introduction of treatment with intravenous iron and only five the following year. A mean increase in haemoglobin of 1.9 g/dL within 7 days was obtained with intravenous iron and of 3.1 g/dL within 14 days without any serious side effect. Discussion and conclusion These results suggest efficacy of treatment with intravenous iron for severe post-partum anaemia with entirely acceptable clinical tolerability. This treatment undoubtedly allows some blood transfusions to be avoided in young women, even though the indication for transfusion is unquestionable in the context of an emergency.