Background: Iron deficiency anemia (IDA) is more prevalent in South Asian countries which accounts for more than half of the maternal death. India is the leader in maternal death due to IDA.

Aims and Objectives: To study improvement in hematological parameters after parenteral Iron sucrose therapy in women undergoing major gynecological surgery.

Materials and Methods: Thirty patients with iron deficiency anemia who were admitted for major gynecological surgery having hemoglobin <10 gm% were studied. Study cohort received 300 to 600 mg of iron sucrose by intravenous route. Hematocrit, mean corpuscular volume and haemoglobin were recorded before and after therapy at the end of one week. All the data were analyzed using IBM SPSS- ver.20 software. P values <0.05 was considered to be significant.

Results: Most of the patients had age >40 years (66.7%), parity >2 (60%), education till 12^th or below (100%) and had monthly income of 2000 or less (60%). Out of 30 patients, 53.3% received iron sucrose whereas 46.75% received iron sucrose with blood transfusion. In 26.7% patients hemoglobin was raised by 0.5 to 1 gm%, in 80% subjects MCV changed up to 10 fL and in 73% of the subjects haematocrit value changed by 5% or more.

Conclusion: Treatment with parenteral iron sucrose with or without blood transfusion is effective in improving hemoglobin concentration in subjects with major gynecological surgery.

Keywords: Iron sucrose, blood transfusion, gynecological surgery, intravenous iron sucrose.

1. Dutta Dc. Text book of obstetrics including perinatology & contraception. 6th ed. Calcutta: New Central Book Agency (P) Ltd; 2004. Anaemia in pregnancy; pp. 262–7.
2. Ezzati M, Lopus AD, Dogers A, Vander HS, Murray C. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360:1347-60. 
3. Toteja GS, Singh P, Dhillon BS. Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India. Food Nutr Bull 2006; 27:311–5. 
4. Kalaivani K. Prevalence and consequences of anaemia in pregnancy. Indian J Med Res 2009; 130:627–33.
5. Silverstein SB, Rodgers GM. Parenteral iron therapy options. Am J Hematol. 2004; 76:74–8. 
6. Charytan C, Levin N, Al-Saloum M, Hafeez T, Gagnon S, Van Wyck DB. Efficacy and safety of iron sucrose for iron deficiency in patients with dialysis-associ-ated anemia: North American clinical trial. Am J Kidney Dis 2001;37:300–7. 
7. Rock WA, Meeks GR. Managing anemia and blood loss in elective gynecologic surgery patients. J Reprod Med 2001; 46: 507-14.
8. Munoz M, Breymann C, Garcia-Erce JA, Gomez Ramirez S, Comin J, Bisbe E. Efficacy and safety of intravenous iron therapy as an alternative/adjunct to allogenic blood transfusion. Int J of Trans Med (VoxSanguinis) 2008; 94 (3):172-83.
9. Diez-Lobo AI, Fisac-Martin MP, Bermejo-Aycar I, Munoz M. Preoperative intrav-enous iron administration corrects anemia and reduces transfusion requirement in women undergoing abdominal hyster-ectomy. Trans Alt in Trans Med 2007; 9 (2): 114-9.
10. Christoph P, Schuller C, Studer H, Irion O, Martinez B, De Tejada et al. Intravenous iron treatment in pregnancy: comparison of high-dose ferric carboxymaltose vs. iron sucrose. J. Perinat. Med 2012;40:469–74
11. Dalal M, Ranjan R, Seth S. Comparison of Oral and Intravenous Iron for Treatment ofIron Deficiency Anaemia in Pregnancy. Indian Medical Gazette 2012:9; 372-75
12. Milman N. Prepartumanaemia: prevention and treatment. Ann Hematol 2008;87:949 – 59.
13. Kriplani A, MaheyR, Dash BB, Kulshreshta V, Agarwal N, Bhatla N. Intravenous iron sucrose therapy for moderate to severe anaemia in pregnancy. Indian J Med Res 2013; 138(1): 78–82.
14. Swami MB, Tiwari N, Sharma P. Intravenous Iron Sucrose Therapy in Anemia with Pregnancy”. Journal of Evolution of Medical and Dental Sciences 2015; 4 (68): 11850-6.
15. Agrawal D, Fotedar S, Kundu S, Mourya M. Iron sucrose infusion in pregnancy: made easy. Annals of Applied Bio-sciences 2014;1:A40-44
16. Morales-Borges RH. Anemia in Pregnancy & Parenteral Iron Therapy. J Blood Disorders Transf 2013; 4: 171.
17. Schröder O, Mickisch O, Seidler U, de Weerth A, Dignass AU, Herfarth H et al. Intravenous iron sucrose versus oral iron supplementation for the treatment of iron deficiency anemia in patients with inflam-matory bowel disease--a randomized, controlled, open-label, multicenter study. Am J Gastroenterol 2005;100(11):2503-9.
18. Perewusnyk G, Huch R, Huch A, Breymann C. Parenteral iron therapy in obstetrics: 8 years experience with iron-sucrose complex. Br J Nutr 2002; 88: 3-10.
19. Shafi D, Purandare SV, Sathe AV. Iron deficiency anemia in pregnancy: intravenous versus oral route. J Obstet Gynaecol India 2012; 62: 317-21.
20. Mays T, Mays T. Intravenous iron-dextran therapy in the treatment of anemia occurring in surgical, gynecologic and obstetric patients. Surg Gynecol Obstet 1976; 143: 381-4.
21. Bhandal N, Russell R. intravenous versus oral iron therapy for postpartum anaemia. BJOG 2006;DOI: 10.1111/j.1471-0528.2006.01062.x
22. Wali A, Mushtaq A, NiloferComparitive study – efficacy, safety and compliance of intravenous iron sucrose and inttram-uscular iron sorbitol in iron deficiency anemia of pregnancy. J Pak Med Assoc 2002 ;52(9): 392-5.

Dr Sujata Bhargava

Associate Professor, Department of Obstetrics & Gynecology,

Sri Aurboindo Institute of Medical Sciences, Indore (MP)

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.