title: Efficacy of intravenous iron for treating postpartum anemia in low-resource African countries: a pilot study in Malawi.
abstract: 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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  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.
authors.affiliation: Department of Anaesthesiology, Sant Joan Despí-Moisès Broggi Hospital, Barcelona, Spain.
authors.forename: Rosario
authors.initials: R
authors.lastname: Armand-Ugón
authors.forename: Teresa
authors.initials: T
authors.lastname: Cheong
authors.forename: George
authors.initials: G
authors.lastname: Matapandewu
authors.forename: Amelia
authors.initials: A
authors.lastname: Rojo-Sanchís
authors.forename: Elvira
authors.initials: E
authors.lastname: Bisbe
authors.forename: Manuel
authors.initials: M
authors.lastname: Muñoz
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000704:Analysis of Variance; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D006452:Hemoglobinometry / Q000295:instrumentation; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007262:Infusions, Intravenous / Q000592:standards / Q000706:statistics & numerical data*; D008295:Malawi; D017063:Outcome Assessment, Health Care / Q000592:standards / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D006473:Postpartum Hemorrhage / Q000188:drug therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000601:surgery; D012424:Rural Population; D013395:Sucrose / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D005290:Ferric Compounds; D006454:Hemoglobins; D013395:Sucrose