Araştırma Makalesi

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

Cilt: 16 Sayı: 4 31 Aralık 2019
Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi Kapak
Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi
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Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia

Öz

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

Kaynakça

  1. 1. Milman N (2011) Postpartum anemia I: definition, prevalence, causes and consequences. Ann Hematol 90:1247–1253 2. Milman N. Anemia—still a major health problem in many parts of the world! Ann Hematol 2011; 90:369–377. 3. World Health Organization (1999) Reduction of maternal mortality. A joint WHO/UNFPA/UNICEF/World Bank statement. World Health Organization, Geneva 4. Potts M, Campbell M (2004) Three meetings and fewer funerals: misoprostol in postpartum hemorrhage. Lancet 364:1110–1111 5. Tsu VD, Shane B (2004) New and underutilized technologies to reduce maternal mortality: call to action from a Bellagio workshop. Int J Gynecol Obstet 85(Suppl 1):S83–S93 6. Bergmann RL, Richter R, Bergmann KE, Dudenhausen JW (2010) Prevalence and risk factors for early postpartum anemia. Eur J Obstet Gynecol Reprod Biol 150:126–131 7. Khalafallah AA, Dennis AE. Iron deficiency anaemia in pregnancy and postpartum: pathophysiology and effect of oral versus intravenous iron therapy. J Pregnancy 2012;2012:630519. doi: 10.1155/2012/630519. Epub 2012 Jun 26. 8. Breymann C, Honegger C, Holzgreve W, Surbek D. Diagnostik und Therapie der Anämie in der Schwangerschaft und postpartal. Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe. Expertenbrief 2007 no. 22 9. Beris P, Maniatis A, on behalf of the NATA working group on intravenous iron therapy. Guidelines on intravenous iron supplementation in surgery and obstetrics/gynecology. Transfusion Alternatives in Transfusion Medicine 2007;9 Suppl 1:29 10. Milman N (2012) Postpartum anemia II: prevention and treatment. Ann Hematol (2012) 91:143–154 11. Venofer®. Summary of Product Characteristics www.medicines. org.uk Accessed February 6th 2011 12. CosmoFer®. Summary of Product Characteristics www.medicines. org.uk Accessed February 6th 2011 13. Ferinject®. Summary of Product Characteristics www.medicines. org.uk Accessed February 6th 2011 14. Lyseng-Williamson KA, Keating GM(2009) Ferric carboxymaltose: a review of its use in iron-deficiency anemia. Drugs 69:739–756 15. Monofer®. Summary of Product Characteristics www.medicines. org.uk Accessed February 6th 2011 16. Van Wyck DB, Martens MG, Seid MH, Baker JB, Mangione A (2007) Intravenous ferric carboxymaltose compared with oral iron in the treatment of postpartum anemia. A randomised controlled trial. Obstet Gynecol 110:267–278 17. Seid MH, Derman RJ, Baker JB, BanachW, Goldberg C, Rogers R (2008) Ferric carboxymaltose injection in the treatment of postpartum iron deficiency anemia: a randomized controlled clinical trial. Am J Obst Gynecol 199:435e1–435e7 18. al-Momen AK, al-Meshari A, al-Nuaim L, Saddique A, Abotalib Z, Khashogji T et al (1996) Intravenous iron sucrose complex in the treatment of iron deficiency anemia during pregnancy. Eur J Obstet Gynecol Reprod Biol 69:121–124 19. al-Ragip A, Unlubilgin E, Kandemir O, Yalvac S, Cakir L, Haberal A (2005) Intravenous versus oral iron for treatment of anemia in pregnancy: a randomized trial. Obstet Gynecol 106:1335–1340 20. Hallak M, Sharon A, Duikman R, Auslender R, Abramovici H (1997) Supplementation iron intravenously in pregnancy. Away to avoid blood transfusions. J Reprod Med 42:99–103

Ayrıntılar

Birincil Dil

İngilizce

Konular

Kadın Hastalıkları ve Doğum

Bölüm

Araştırma Makalesi

Yazarlar

Yayımlanma Tarihi

31 Aralık 2019

Gönderilme Tarihi

29 Aralık 2019

Kabul Tarihi

31 Aralık 2019

Yayımlandığı Sayı

Yıl 2019 Cilt: 16 Sayı: 4

IZ

https://izlik.org/JA79PC52NH

Kaynak Göster

RIS / Bibtex
APA
Demirel, Z., Güler, A. E., Aktürk, E., & Atasever, M. (2019). Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 16(4), 207-210. https://izlik.org/JA79PC52NH
AMA
1.Demirel Z, Güler AE, Aktürk E, Atasever M. Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia. JGON. 2019;16(4):207-210. https://izlik.org/JA79PC52NH
Chicago
Demirel, Zeliha, Aşkın Evren Güler, Erhan Aktürk, ve Melahat Atasever. 2019. “Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia”. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 16 (4): 207-10. https://izlik.org/JA79PC52NH.
EndNote
Demirel Z, Güler AE, Aktürk E, Atasever M (01 Aralık 2019) Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 16 4 207–210.
IEEE
[1]Z. Demirel, A. E. Güler, E. Aktürk, ve M. Atasever, “Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia”, JGON, c. 16, sy 4, ss. 207–210, Ara. 2019, [çevrimiçi]. Erişim adresi: https://izlik.org/JA79PC52NH
ISNAD
Demirel, Zeliha - Güler, Aşkın Evren - Aktürk, Erhan - Atasever, Melahat. “Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia”. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 16/4 (01 Aralık 2019): 207-210. https://izlik.org/JA79PC52NH.
JAMA
1.Demirel Z, Güler AE, Aktürk E, Atasever M. Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia. JGON. 2019;16:207–210.
MLA
Demirel, Zeliha, vd. “Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia”. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, c. 16, sy 4, Aralık 2019, ss. 207-10, https://izlik.org/JA79PC52NH.
Vancouver
1.Zeliha Demirel, Aşkın Evren Güler, Erhan Aktürk, Melahat Atasever. Comparison of Intravenous Iron Infusion or Oral Iron for Treatment of Moderate Postpartum Anemia. JGON [Internet]. 01 Aralık 2019;16(4):207-10. Erişim adresi: https://izlik.org/JA79PC52NH