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Obstetrics and Gynecology
Resident PGY 4
Henry Ford Hospital
Objective: Iron deficiency anemia is seen commonly in women of reproductive age and particularly during pregnancy. Current treatment practice with oral iron supplementation is associated with gastrointestinal side effects leading to poor compliance. Intravenous dextran is an effective alternative that is underutilized which can lead to better clinical outcomes, reduced risk of blood transfusion as well as improved quality of life. Our objective was to study improvement inquality of life in patients receiving intravenous iron using validated questionnaires.
Study Design: A pilot prospective study was performed involving 29 patients with a hemoglobin levels between 8 and 10 g/dL and/or a low ferritin <200 µg/L, referred by their obstetric provider for inability to tolerate oral iron. Patients received intravenous iron dextran, at a fixed dose of 1000mg. Hematologic (response defined by hemoglobin normalization) and quality-of-life [Health-Related Quality of Life (HRQOL) and 36-Item Short Form Survey (SF-36) questionnaire] evaluations were performed at baseline and at 30 and 90 days. Exclusion criteria included hypersensitivity of parental iron, severe hepatic impairment, malignancy, and pre-existing cardiovascular disease.
Results: Of 33 patients recruited, 29 received intravenous iron dextran. In 2 patients, the medication had to discontinued due to adverse effect; hypotension and urticaria. Mean basal hemoglobin levels were 8.8 g/dL (range, 7.0-10.3). Hemoglobin normalization (improvement of HgB > 11g/dL) was achieved in 55.5% of the patients. Improvement of more than 1 g/dL was noted in 88% of the patients. The quality-of-life scores correlated with improvement in hemoglobin and were increased in patients who normalized their hemoglobin in 3 months and 6 months.
Conclusion: Intravenous iron is an effective and safe alternative for iron deficiency anemia in intolerant patient. Our study aims to analyze the anemia correction with iron treatment is associated with a relevant improvement in the patients' quality of life.
Saeed, Haleema; Shukr, Ghadear; and Sangha, Roopina, "IV iron: Opportunities for Clinical Optimization of Women with Iron Deficiency Anemia" (2019). Clinical Research. 42.