Department of Anaesthesiology, Sant Joan Despí-Moisès Broggi Hospital, Barcelona, Spain.
J Womens Health (Larchmt). 2011 Jan;20(1):123-7. doi: 10.1089/jwh.2010.2192. Epub 2010 Nov 22.
Postpartum hemorrhage may lead to maternal morbidity and mortality, increases risks of transfusion, and incurs costs. We report on the feasibility and efficacy of in-hospital intravenous (IV) iron for treating postoperative anemia at Mtengo wa Nthenga, Malawi.
Twenty-eight consecutive women undergoing surgery for complicated pregnancy or complicated childbirth entered the study. Patients with hemoglobin (Hb) <10 g/dL on postoperative day 1 (n = 14) received IV iron sucrose (200 mg/day, 3 consecutive days), and those with Hb ≥10 g/dL (n = 14) received oral iron (ferrous sulfate, 256 mg/day). In-hospital postoperative Hb increase and blood transfusion were recorded.
Mean changes in Hb from postoperative day 1 to postoperative day 7 were -0.6 ± 1.2 g/dL and 2.1 ± 1.7 g/dL, for the oral and IV iron groups, respectively (p = 0.001). No side effect was seen with IV iron. Only 1 of 4 women receiving allogeneic blood was transfused after the initiation of IV iron treatment.
Our results suggest that IV iron sucrose is an effective drug for treating puerperal anemia, leading to a rapid recovery of Hb levels. The current availability of generic iron sucrose preparations, with considerably lower acquisition costs, may facilitate in-hospital access to this treatment option in low-resource countries.
产后出血可能导致产妇发病率和死亡率增加，增加输血风险，并产生费用。我们报告在姆滕戈瓦恩滕加，马拉维，静脉内（IV）铁治疗产后贫血的可行性和疗效。
28 例连续接受复杂妊娠或复杂分娩手术的妇女进入研究。术后第 1 天血红蛋白（Hb）<10 g/dL 的患者（n=14）接受静脉铁蔗糖（200 mg/天，连续 3 天），Hb≥10 g/dL 的患者（n=14）接受口服铁（硫酸亚铁，256 mg/天）。记录住院期间术后 Hb 增加和输血情况。
口服和 IV 铁组术后第 1 天至第 7 天 Hb 的平均变化分别为-0.6±1.2 g/dL 和 2.1±1.7 g/dL（p<0.001）。静脉铁无副作用。仅在开始 IV 铁治疗后，接受同种异体输血的 4 名妇女中有 1 名输血。
我们的结果表明，静脉铁蔗糖是治疗产褥期贫血的有效药物，可迅速恢复 Hb 水平。目前普通铁蔗糖制剂的可用性，具有较低的获得成本，可能有助于在资源有限的国家获得这种治疗选择。
