Open AccessPF812 INTRAVENOUS IRON SUPPLEMENTATION PROTOCOL FOR POST‐PARTUM ANEMIA
Author(s) -
Volpato E.,
Cuppari I.,
Lissoni D.,
Pugliano M.T.,
Crocchiolo R.,
Rossini S.
Publication year - 2019
Publication title -
hemasphere
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 11
ISSN - 2572-9241
DOI - 10.1097/01.hs9.0000561528.59589.90
Subject(s) - medicine , post partum , anemia , pregnancy , caesarean section , intravenous iron , hemoglobin , population , obstetrics , pediatrics , iron deficiency anemia , blood loss , iron deficiency , surgery , environmental health , genetics , biology
Background: The World Health Organization (WHO) determines as post‐partum anemia values of harmoglobin (Hb) less than 10 g/dl. In most cases, it's an iron deficiency anemia and affects about the 27% of new mothers and has as a consequence a strong socio‐economic impact. One of the most important causes is the post partum haemorrhage (PPH), that's to say 500 ml of blood loss in the first 24 hours after a vaginal delivery or more than 1000 ml after a caesarean section. Nowadays PPH is one of the most common causes of mortality and morbidity rate among obstetric population and its frequency is between the 5% and the 22 % of the total deliveries. Aims: The objective of the present study is to determine the efficacy of an iron supplementation protocol for post‐èartum anemia. Methods: Our protocol provides a valuation of Hb in the post partum period. When Hb is greater than 8..5 g/dl, the new mother can be discharged from hospital and is treated by oral iron supplementaion with ferrous sulfate but it will be necessary to control the Hb value after 30 days. In case of HB belove 8..5 g/dl, parenteral iron is used (iron carbossymaltose) in the Obstretician Unit, then there will be a new assessment after 10/15 days at Service of Immunohaematology and Trasfusional Medicine to decide if to go on supplementation. Results: From 01/06/2017 to 31/12/2018 36 new mothers, average age 34 years (range 23 ‐ 43) have been enrolled. During the recovery, 34 new mothers have been treated with ferric carboxymaltose: 26 with a dosage of 500 mg and 8 with 1 g. Among these 34 women, 4 have been trasfused after a severe PPH and concomitant thalassaemic trait. Only 2 of the new mothers have been discharged with ferrous sulfate. At discharge, average Hb was 7.3 g/dl. At first access in Transfusional Center, the average Hb value was 10.8 g/dl with a medium delta of 3.5 g/dl. According to the hemoglobin values, 18 new mothers have continued oral iron therapy, 14 have been treated with ferric carboxymaltose and only 2 didn’t need therapy. Summary/Conclusion: Our protocol has been implemented thanks to the indications of National Blood Center about the PMB to ensure, through the multidisciplinarity, the transfusion appropriatness, the resource optimization and the improvement of the patient's outcome. The intravenous iron therapy with ferric carboxymaltose in new mothers suffering a severe iron deficiency anemia allows a fast rise of hemoglobin values and an improvment of psychophysical wellbeing of the new mother and a lowering of the number of blood transfusions.