The treatment of iron deficiency anemia of pregnancy with intravenous iron

1.1. Twenty-six patients were treated with intravenous saccharated oxide of iron. Nine had iron deficiency anemia with hemoglobins varying from 5.4 to 10 Gm. per 100 c.c. of whole blood. Eight patients had hemoglobins of 10.5 Gm. Nine patients had normal hemoglobin.2.2. Results indicate that in iron deficiency anemia of pregnancy, intravenous iron produces a greater total and a more rapid increase in hemoglobin than oral iron. The average increase in these patients was 1 Gm. hemoglobin per 100 c.c. of whole blood in one week, and 2 Gm. in two weeks, and as high as 4.05 Gm. in 4 to 6 weeks. The volume of packed red blood cells and serum iron levels substantiate these findings.3.3. Toxic reactions were significant. Doses varied from less than 100 mg. to as high as 1 Gm. of intravenous iron. Sixty-five per cent resulted in no reactions, 27 per cent mild, 6 per cent moderately severe, and 2 per cent severe. Most frequent reactions were light-headedness, suffusion, weakness, nausea, venospasm, headache, sacral backache. Thrombophlebitis and shocklike state occurred twice, both times with large doses.4.4. Following a test dose of 100 mg., up to 300 mg. of intravenous saccharated oxide of iron can be given daily without materially increasing toxic reactions. Doses of 100 to 200 mg. are recommended.5.5. The best method of injection is to dilute the saccharated oxide of iron solution in the patient's own blood. Injection should be done slowly and care taken to avoid subcutaneous injection of the material.6.6. Intravenous saccharated oxide of iron for the treatment of iron deficiency anemia of pregnancy is effective in those patients who cannot tolerate iron by mouth, who have excessive nausea and vomiting of pregnancy, who have failure of absorption of iron from the gastrointestinal tract, and who present themselves late in pregnancy with an existing anemia and insufficient time for response to oral therapy.