Stemming the rising tide of Iron Deficiency Anemia in Pregnancy Is Intravenous Iron Sucrose a viable alternative to the fa...
Study Objectives <ul><li>To determine the current prevalence and severity of  IDA in pregnancy in rural and urban populati...
Anemia scenario in India <ul><li>Prevalence in pregnant women: 87% </li></ul><ul><li>Contribution to maternal deaths: 16% ...
Anemia scenario in India <ul><li>A vast  majority of women in rural India embark upon pregnancy with frank iron deficiency...
Objective 1 - Prevalence <ul><li>To determine the current prevalence and severity of IDA in pregnancy in rural and urban p...
Objective 1 - Severity <ul><li>The majority of anemic women in the rural population pregnant women had a moderate degree o...
Objective 1 - Severity
Conclusion 1 <ul><li>In India, prevalence of IDA is rising </li></ul>
We are still talking about it …. <ul><li>In India, the iron-folic acid (IFA) </li></ul><ul><li>supplementation program was...
Objective 2 – Document Response to IFA Supplementation program <ul><li>Traditional Treatment – Oral Iron Folic Acid Supple...
Response to Oral Iron Folic Acid Supplements
Conclusion 2 <ul><li>The IFA program has failed to eradicate IDA in pregnancy </li></ul>
Irrefutable evidence <ul><li>IV iron sucrose results in a much more rapid resolution of IDA and because it is administered...
Objective 3 – Pilot the response to intravenous iron-sucrose <ul><li>Two doses of IV iron sucrose (200mg each) were admini...
Objective 3 –  Response to  IV Iron Sucrose <ul><li>Fall in the percentage of women with moderate anemia at 4 weeks follow...
Objective 3 – Response to  IV Iron Sucrose <ul><li>92.7% registered a rise in Hb across all ranges of anemia when given IV...
Conclusion 3 <ul><li>Intravenous Iron Sucrose may be the solution, but rigorous research and evaluation will be required t...
<ul><li>Anemia is a neglected tragedy that continues to exact a heavy toll of suffering and death on women, while there ar...
<ul><li>Thank you for viewing this presentation </li></ul><ul><li>Dr Hema Divakar, Consultant Obstetrician at Divakar’s Gl...
Upcoming SlideShare
Loading in...5
×

Stemming The Rising Tide Of Iron Deficiency Anemia In India

3,275

Published on

A study on use of IV Iron Sucrose in treatment of Iron Deficiency Anemia in Pregnancy in India.

Published in: Health & Medicine, Technology
2 Comments
3 Likes
Statistics
Notes
No Downloads
Views
Total Views
3,275
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
79
Comments
2
Likes
3
Embeds 0
No embeds

No notes for slide

Stemming The Rising Tide Of Iron Deficiency Anemia In India

  1. 1. Stemming the rising tide of Iron Deficiency Anemia in Pregnancy Is Intravenous Iron Sucrose a viable alternative to the failed Iron-Folate supplementation program in India? Hema Divakar, MD, Consultant Obstetrician, Nandakumar BS, MD, Public Health Consultant Isaac Manyonda, PhD, MRCOG, Consultant Obstetrician
  2. 2. Study Objectives <ul><li>To determine the current prevalence and severity of IDA in pregnancy in rural and urban populations in India </li></ul><ul><li>To prospectively document the response to an IFA supplementation program </li></ul><ul><li>To pilot the response to intravenous iron-sucrose </li></ul>
  3. 3. Anemia scenario in India <ul><li>Prevalence in pregnant women: 87% </li></ul><ul><li>Contribution to maternal deaths: 16% </li></ul>
  4. 4. Anemia scenario in India <ul><li>A vast majority of women in rural India embark upon pregnancy with frank iron deficiency anemia and/or depleted iron stores </li></ul>
  5. 5. Objective 1 - Prevalence <ul><li>To determine the current prevalence and severity of IDA in pregnancy in rural and urban populations in India </li></ul>Among 10,000 rural ante-natal women 6,948 (69.4%) were found to be anemic, while among 1985 urban ante-natal women 1,247 (61.4%) were anemic. The difference in prevalence of anemia between rural and urban pregnant women was statistically significant (p<0.001)
  6. 6. Objective 1 - Severity <ul><li>The majority of anemic women in the rural population pregnant women had a moderate degree of anemia (43.5%) </li></ul><ul><li>while the majority in the urban women had a mild degree of anemia (35.7%) </li></ul>
  7. 7. Objective 1 - Severity
  8. 8. Conclusion 1 <ul><li>In India, prevalence of IDA is rising </li></ul>
  9. 9. We are still talking about it …. <ul><li>In India, the iron-folic acid (IFA) </li></ul><ul><li>supplementation program was launched more than 30 years ago (1970) </li></ul><ul><li>yet </li></ul><ul><li>IDA remains a major challenge. </li></ul><ul><li>Only 10% of women consume </li></ul><ul><li>correctly! </li></ul><ul><li>(Indian J Med Res 2006:124:173-184) </li></ul>
  10. 10. Objective 2 – Document Response to IFA Supplementation program <ul><li>Traditional Treatment – Oral Iron Folic Acid Supplements </li></ul><ul><li>Oral iron-folate was administered at 200mg once daily for 10 weeks after deworming with mebendazole </li></ul><ul><li>Hb estimations were performed before and after the 10 week course of therapy </li></ul><ul><li>Women with unchanged Hb, or those whose Hb fell compared to pre-treatment values, were considered non-responders </li></ul>
  11. 11. Response to Oral Iron Folic Acid Supplements
  12. 12. Conclusion 2 <ul><li>The IFA program has failed to eradicate IDA in pregnancy </li></ul>
  13. 13. Irrefutable evidence <ul><li>IV iron sucrose results in a much more rapid resolution of IDA and because it is administered intravenously, it circumvents the problems of compliance. </li></ul><ul><li>Am J Obstet Gynecol 2002;88:3-10. </li></ul><ul><li>Eur J Obstet Gynecol Reprod Biol 1996;69:121-124. </li></ul><ul><li>If oral iron does not work, switch quickly to intravenous iron, don’t waste your & your patient’s time </li></ul><ul><li>Scott, Govan, Lancet -1949 Jan, 253(6540) 14-7 </li></ul><ul><li>Holds good even after 50 yrs! </li></ul>
  14. 14. Objective 3 – Pilot the response to intravenous iron-sucrose <ul><li>Two doses of IV iron sucrose (200mg each) were administered on alternate days. </li></ul><ul><li>Hb was assessed prior to treatment, and again at 4 weeks after therapy. </li></ul>
  15. 15. Objective 3 – Response to IV Iron Sucrose <ul><li>Fall in the percentage of women with moderate anemia at 4 weeks following treatment with 400mg intravenous iron </li></ul>On a study of 152 pts – group A - IV push group B - IV infusion Both equally effective - IV bolus push is less costly, more compliance
  16. 16. Objective 3 – Response to IV Iron Sucrose <ul><li>92.7% registered a rise in Hb across all ranges of anemia when given IV sucrose as against 35% responders in the oral group </li></ul>
  17. 17. Conclusion 3 <ul><li>Intravenous Iron Sucrose may be the solution, but rigorous research and evaluation will be required to establish its full place and potential. </li></ul>
  18. 18. <ul><li>Anemia is a neglected tragedy that continues to exact a heavy toll of suffering and death on women, while there are also the not-so-obvious but potentially just as devastating sequelae on the newborn child’s motor and intellectual development, and future risk of cardiovascular disease. </li></ul>
  19. 19. <ul><li>Thank you for viewing this presentation </li></ul><ul><li>Dr Hema Divakar, Consultant Obstetrician at Divakar’s Global Hospital carries out field research to solve some of the basic problems in the OBGYN space in India. </li></ul><ul><li>Visit http://www.abcofobg.com for more details. </li></ul>
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×