Efficacy of intravenous iron for treating postpartum anemia in low-resource african countries: A pilot study in Malawi

Background: 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. Patients and methods: Twenty-eight consecutive women undergoing surgery for complicated pregnancy or complicated childbirth entered the study. Patients with hemoglobin (Hb) <10g/dL on postoperative day 1 (n=14) received IV iron sucrose (200mg/day, 3 consecutive days), and those with Hb ≥10g/dL (n=14) received oral iron (ferrous sulfate, 256mg/day). In-hospital postoperative Hb increase and blood transfusion were recorded. Results: Mean changes in Hb from postoperative day 1 to postoperative day 7 were-0.6±1.2g/dL and 2.1±1.7g/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. Conclusions: 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. © 2011, Mary Ann Liebert, Inc.