ABSTRACT

Aim: To compare safety and efficacy of IV iron sucrose complex (ISC) and parenteral ferric carboxymaltose (FCM) injection to correct postpartum iron deficiency anemia.

Study design: Randomized controlled trial

Place and duration of study: Obstetrics & Gynecology Unit 4, Sir Ganga Ram Hospital, Lahore from 1st September 2020 to 31st 2021.

Methodology: One hundred and sixty women were recruited and they were divided in two equal groups Group A received two doses intravenous iron sucrose complex 200 mg on day 2 and day 4 and Group B was given intravenous ferric carboxymaltose. Dosage of ferric carboxymaltose was given on weekly until the individual’s calculated cumulative dose was achieved. There was follow up of the patients who were treated with ferric carboxymaltose and iron sucrose complex after being discharged from the hospital at day 21.

Results: The mean age of intravenous iron sucrose complex (Group A) was 26.16±5.17 years and Group B (ferric carboxymaltose) the mean age was 26.86±4.32 years. The mean BMI was 24.09±0.77 in Group A and 24.56±1.42 in group B. In group A, the mean percentage improvement was 36.42±7.61% and in group B it was 56.62±5.56% with statistically higher improvement in group B than group A (P<0.001). At 21st day, 18 (22.5%) females in group A and 65 (81.2%) females in group-B had Hb levels >12 g/dl which was statistically significant. In group A, only 6 (7.5%) females and 34 (42.5%) in group B females benefitted from the treatment with significantly higher efficacy in group B (P<0.0001). Complications in group A were seen in 67 (83.8%) in group A and 75 (93.8%) in group B respectively with higher safety profile in group B (P<0.05).

Conclusion: Ferric carboxyl maltose injection had higher improvement in hemoglobin and other parameters, higher efficacy and safety profile with negligible complications than Iron sucrose Complex. So, ferric carboxyl maltose injection can be utilized for correction of post-partum anemia that can help in delivering health benefits to the mother.

Keywords: Pregnancy, Postpartum blood loss, postpartum anemia, Ferric carboxymaltose, Iron sucrose complex, Efficacy