The Use of Recombinant Human Erythropoietin (rhEPO) in Treatment of Iron Deficiency Anemia during Pregnancy
Abstract
ABSTRACT
Background: Pregnant women are at high risk of iron deficiency anemia. Both mothers and fetuses may get deleterious complications secondary to untreated iron deficiency anemia, therefore; effective rapid treatment is recommended other than high dose oral therapy or blood transfusion
Objectives: Evaluation of the adjuvant use of recombinant human erythropoietin therapy (rhEPO) in combination with parenteral iron sucrose infusion therapy in the treatment of gestational iron deficiency anemia
Methods: Twenty pregnant ladies in their third trimester with iron deficiency anemia were enrolled in this study. After exclusion of other causes of anemia, they were distributed equally in 2 groups. Group A for those receiving recombinant human erythropoietin therapies in combination of total dose intravenous infusion of iron sucrose and group B for those receiving iron sucrose only in total infusion dose. Hematocrit, reticulocyte, iron saturation and serum ferritin were determined initially and then followed accordingly for each group within subsequent 4 weeks as response parameters. Adverse reactions were also reported
Results: Both groups showed an immediate reticulocyte response and continuous increase in hematocrit within first week of treatment, however; Group A (with rhEPO) had earlier and higher reticulocyte counts increment than group B from day 4 of treatment and similar greater increases in hematocrit from day 11 with only one patient didn't reach full correction of hemoglobin 11 g/dL. Mean durations of complete response were 10 days in group A and 24 days in group B. Serum ferritin level and transferrin saturation increased continuously until the end of therapy for both groups. There were no serious adverse reactions to both.
Conclusion: This study shows that intravenous iron sucrose is a safe option for the treatment of iron deficiency anemia in pregnancy and the use of adjuvant recombinant human erythropoietin can safely enhance the efficacy of iron sucrose in the treatment of gestational iron-deficiency anemia that did not respond to oral supplementation, cases near term or in the presence of obstetric risk factors.
Copyright (c) 2012 Iraqi Medical Journal
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