Effect of intravenous iron sucrose on hemoglobin level, when administered in a standard dose, to anemic pregnant women in rural Northern India
Year: 2019
Type: article
Abstract: Dear Respectable Editor, While we are reading the article published by Haldar et al. (J Family Med Prim Care. 2018;7 (4):762-768. Doi: 10.4103/jfmpc.jfmpc_303_17) with great interest, there are many queries raised in our minds. We will be grateful if the authors clarify to us and to the readers the answers of the following queries. First, Haldar et al. stated that they assessed the effect of intravenous iron sucrose (IVIS) on hemoglobin (Hb) levels among the pregnant anemic women.[1] Other authors mentioned that the IVIS should be used for treatment of iron deficiency (ID) and iron deficiency anemia (IDA), and the diagnosis of IDA should be based the following parameters: Hb concentration (g/dl), serum ferritin (μg/l), mean corpuscular volume (MCV), and mean corpuscular Hb (MCH).[23456] We think that Haldar et al.[1] should include in their study women with IDA only.[23] Second, Haldar et al.[1] stated that pregnant women, identified as moderately or severely anemic (Hb <10.0 g/dl) in the second or third trimester during routine antenatal care, were prescribed IVIS in a standard dose of 400 mg given as 100 mg on alternate days without dose calculation or allowance for iron store was included in their study.[1] Other authors stated that total IVIS dose for correction of IDA should be given and calculated following manufacturer's instructions: total iron needed in mg = 2.4 × prepregnancy weight in kg × (target Hb − actual Hb) g/dl + 500 mg. About 12 g/dl is the target Hb concentration, 2.4 is correction factor, and 500 mg is the amount of stored iron in pregnant adult women.[2345678] Please clarify to us and to the readers, which type of anemia in pregnancy can be treated by IVIS, how to diagnose IDA, and the ideal method for calculation of the total IVIS dose for correction of IDA during pregnancy. Conclusion IVIS should be used for treatment of ID and IDA only and the IDA can be diagnosed by the following parameters: Hb concentration, serum ferritin, MCV, and MCH. The parenteral total IVIS dose for treatment of IDA should be calculated and given according to the manufacturer's instruction as follow: total iron needed in mg = 2.4 × prepregnancy weight × (target Hb − actual Hb) g/dl + 500 mg. Ethical approval This article does not contain any studies with human or animal subjects performed by any of the authors. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $450
OpenAlex ID: W2917376901