الفهرس 
Chapter I: AnemiaOnly 14 pages are availabe for public view
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Abstract
Iron deficiency anaemia remains the commonest medical disorder in pregnancy in developing world, Iron deficiency which can result in fatigue, irritability, headaches, lack of energy. There are various possible forms of treatment for iron deficiency anemia. Blood transfusion has its own hazards, including transfusion of wrong blood and deadly infections like HIV, CMV, hepatitis and anaphylaxis. Thus, there is a need for a safe and alternative to blood transfusion in the treatment of anemia.
Oral iron is the preferred route of administration for treatment of iron deficiency anaemia. However, oral iron supplementation often leads to adverse effects, such as constipation, abdominal pain, or sickness. If these unwanted gastrointestinal effects arise, adherence to oral iron treatment decreases.
New oral iron drugs discovered to overcome the side effect of the oral. The sprinkle-sized particles of ferrous fumarate are coated with a mono or diglyceride (hydrogenatedsoy lipid) and this thin coating protects the iron from food (and food from the iron) and also masks the taste of the iron.
The aim of this study was to compare the efficacy and tolerability of intravenous iron sucrose therapy with oral microencapsulated iron therapy in pregnant women with iron deficiency anaemia.
A cohort study involved 86 pregnant women between 14 and 36 weeks with established iron deficiency anemia attending the Obstetrics and Gynecology outpatient clinic at Menoufia teaching hospital and El-Shohada Hospital, Menoufia governorate, Egypt, during the period from December 2016 to October 2018.
All patients divided equally into 2 groups each contain 43. The allocation sequence is concealed in sequentially numbered, opaque, sealed envelopes. This process prepared by a statistician.
group A: included 43 patients who received intravenous iron therapy (Ferosac 100mg/5ml/ampoule).
group B: included 43 patients who received oral microencapsulated iron (Vitayami multivitamins).
The dose for IVIS was calculated from the following formula: according (83)
Dose (mg) = [250 - (target Hb (11 g/dL) -present Hb) +500 mg (for iron stores)]
Inclusion criteria:
Singleton pregnancy.
Moderate anemia in pregnancy (7-10.9g%).
No history of allergy to I.V iron.
Exclusion criteria:
Women with severe anemia requiring blood transfusion, bronchial asthma and suspected acute infection were excluded from the study.
Anemia due to haemoglobinopathies, chronic bleeding, diseases of liver, cardiovascular system and kidney.
Medical disorders like tuberculosis and diabetes mellitus with anemia.
Women who have taken any form of parenteral iron therapy for anemia during the present pregnancy.
Patients with antepartum hemorrhage.
Intolerance to iron or any allergic reaction to iron.
Summary
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History of any allergic reaction to iron in past these study was undertaken to find out the usefulness of iron sucrose for the treatment of iron deficiency anaemia in pregnancy.
All pregnant women who fulfill the eligibility criteria were subjected to:
Complete History taking: with emphasis history of onset, course and duration of labor pains, vaginal gush of fluid, vaginal discharge, vaginal bleeding, or febrile illness, history of previous preterm labor, previous abortion, previous full-term deliveries, mode of delivery and fetal outcome.
General examination:
Vital signs and symptoms: focusing on blood pressure to exclude pregnancy induced hypertension, pulse, temperature and respiratory rate and patients’ texture.
Head and neck examination: for, pallor, edema of the eye lids.
Chest and heart examination, for abnormal findings.
Abdominal examination: with emphasis on the fundal height, clinically estimated fetal weight and presence of uterine contractions.
Laboratory investigation:
Complete blood count
Serum ferritin
Serum transferrin.
Total iron binding capacity
Results of the current study could be summarized as follow:
Hemoglobin and serum ferritin were significantly higher in iron sucrose group than Oral Microencapsulated Iron after treatment.
Hemoglobin and serum ferritin before treatment were not significantly difference among the studied groups.
Women who treated by Iron Sucrose had significantly lower TIBC and transferrin before and after treatment as compared those treated by Oral Microencapsulated Iron.
There was statistically highly significant difference between the studied groups regarding parity (p=0.001).
Women who treated by Iron Sucrose had lower side effects than whose treated by Oral Microencapsulated Iron.
Both groups under study had significantly higher hemoglobin and serum ferritin after treatment as compared before treatment.
Both groups under study had significantly lower total iron binding capacity and transferrin after treatment as compared before treatment. There was highly significant difference between the studied groups regarding their age (p<0.001).