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Comparing the safety and efficacy of intravenous iron sucrose and intravenous ferric carboxymaltose in treating postpartum anemia

Background Anaemia is the most common hematological abnormality diagnosed during pregnancy. As per WHO, anaemia during pregnancy is defined as haemoglobin concentration of less than 11 gm% (7.45mmol/L) and haematocrit less than 33%. The objective of this study was to compare the safety and efficacy of intravenous iron sucrose and i.v. ferric carboxymaltose in treating postpartum anemia.

Methods This open label, interventional, prospective study was carried out in 200 postpartum patients with Anemia in the department of obstetrics and gynecology, LLRM Medical College, Meerut, Uttar Pradesh, India from November 2014 to November 2015. The subjects were randomized in 1:1 ratio of two groups. First approved receiving 500 mg of intravenous iron sucrose divided in three doses on alternate days (200 mg, 200 mg, and 100 mg).  Second receiving 500 mg of intravenous ferric carboxymaltose (Ferium, Emcure Pharmaceuticals).

Results Maximum number of patients of our study belonged to low socioeconomic group, significantly higher number of women achieved Hb >11gm/dl in FCM group.88 women in FCM group achieve Hb rise of 2 gm as compared to only 24 in iron sucrose group, which was highly significant (P value <0.001) mean size of Hb was 2.086 mg for FCM group and 1.766 gm for iron sucrose group, which was also significant. Serum ferritin, which is a marker of iron stores rise much higher 67.6 mg/ml in ferric carboxymaltose group as compared to 47.88 mg/ml for iron sucrose group.

Conclusions Ferric carboxymaltose is an efficient alternative to Iron Sucrose in treating postpartum anemia. It has an added advantage of single dose regime and lower incidence of side effects.