title: Single-dose intravenous iron infusion versus red blood cell transfusion for the treatment of severe postpartum anaemia: a randomized controlled pilot study.
abstract: OBJECTIVE
  There are no randomized trials comparing intravenous iron to RBC transfusion for the treatment of severe postpartum anaemia. The objectives of this study were to evaluate the feasibility of randomizing women with severe postpartum anaemia secondary to postpartum haemorrhage to RBC transfusion or intravenous iron, and to describe patient-reported outcomes, and haematological and iron parameters.
  
  
  METHODS
  Women with a postpartum haemorrhage exceeding 1000 ml and an Hb between 5·6 and 8·1 g/dl were randomized to 1500 mg of intravenous iron (n = 7) isomaltoside or RBC transfusion (n = 6). Participants completed the Multidimensional Fatigue Inventory and Edinburgh Postnatal Depression Scale, and blood samples were drawn at inclusion, daily during the first week and at weeks 3, 8 and 12.
  
  
  RESULTS
  We screened 162 women and included 13 (8%). There was no significant difference between groups in fatigue or depression scores. RBC transfusion was associated with a higher Hb on day 1, inhibition of reticulocytosis during the first week and low iron levels. Intravenous iron was associated with increased reticulocytosis during the first week, repleted iron stores and a higher Hb in weeks 3-12.
  
  
  CONCLUSIONS
  This pilot study shows that intravenous iron could be an attractive alternative to RBC transfusion in severe postpartum anaemia, and that a larger trial is needed and feasible.
authors.affiliation: Department of Obstetrics, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.|Pharmacosmos A/S, Holbaek, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Holm
authors.affiliation: Pharmacosmos A/S, Holbaek, Denmark.
authors.forename: L L
authors.initials: LL
authors.lastname: Thomsen
authors.affiliation: Section for Transfusion Medicine, Capital Region Blood Bank, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Norgaard
authors.affiliation: Department of Obstetrics, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Langhoff-Roos
mesh_terms: D000328:Adult; D000740:Anemia / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D003863:Depression / Q000473:pathology; D004187:Disaccharides / Q000008:administration & dosage* / Q000494:pharmacology; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005221:Fatigue; D005240:Feasibility Studies; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage* / Q000494:pharmacology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007262:Infusions, Intravenous; D010865:Pilot Projects; D006473:Postpartum Hemorrhage / Q000209:etiology; D049590:Postpartum Period; D011247:Pregnancy; D045262:Reticulocytosis / Q000187:drug effects; D012720:Severity of Illness Index
chemical_list: D004187:Disaccharides; D005290:Ferric Compounds; D006454:Hemoglobins; C557707:iron isomaltoside 1000
keywords: clinical trial; haemoglobin measurement; medicine; patient blood management; transfusion