Abstract
Background: The use of intravenous (IV) iron sucrose was approved for the obstetric and gynecologic (OBGYN) population at our mother-child teaching hospital in 2006 for intolerance or nonresponse to oral iron supplements, contraindication to intramuscular (IM) iron, and rapid increase of the hemoglobin desired in iron-deficient patients. Objectives: (a) To describe the indications and doses of IV iron sucrose used in OBGYN, (b) to assess monitoring, and (c) to describe the adverse effect profile. Methods: A retrospective study of patients admitted to the OBGYN wards with at least one prescription of IV iron from January 1, 2006, to March 31, 2010, was conducted. A standardized data collection sheet was used to record data. Results: A total of 164 prescriptions of IV iron were reviewed in 128 women. The indications for IV iron were anemia before delivery (n = 76), intolerance or no response to oral iron (n = 61), or intolerance or contraindication to IM iron (n = 27). Fourteen doses (9%) were appropriate, and the others were too low. Prior to prescription, ferritin or serum iron levels were assessed in 31% of women and hemoglobin electrophoresis in nearly all of Black or Asian women. One-week follow-up hemoglobin levels were measured after 66 prescriptions (40.2%). Adverse effects, mostly pain at the injection site, were reported in 18 (11%) occasions. Conclusions: IV iron is prescribed in OBGYN patients to obtain a rapid hemoglobin increase or when oral iron is not tolerated or inefficacious. The dose prescribed is generally too low, baseline essential testing often omitted, and appropriate follow-up monitoring incomplete. IV iron is well tolerated.