Postpartum and early postoperative anemia after gynecological surgery: treatment with intravenous iron

OBJECTIVE: To assess the efficacy and safety of treatment with intravenous iron for postpartum anemia or postoperative anemia after gynecological surgery. PATIENTS AND METHODS: A prospective study enrolling patients entering our recovery care unit from June through December 2004 with hemoglobin levels less than 10 g x dL(-1) after vaginal childbirth or cesarean section or after another form of gynecological surgery. Three 200 mg doses of intravenous iron sucrose (Venofer) were administered on consecutive days. Fifteen days after the last dose, the patient came for follow-up tests and was asked about side effects. The results were analyzed with a Student t test for matched samples. RESULTS: A total of 250 obstetric and 52 gynecological surgery patients were enrolled; 156 and 33 completed the study in each group, respectively. Hemoglobin increased after treatment by 3.2 g x dL(-1) in the obstetric patients and by 2.7 g x dL(-1) in patients who underwent gynecological surgery. The increase was significant in both groups (P<0.001); the 95% confidence interval was 2.918-3.519 for the obstetric patients and 2.220-3.071 for the gynecological surgery patients. The incidence of side effects was low (13 obstetric patients and 1 gynecological surgery patient). Most side effects were related to pain at the injection site (in 12 of the 14 women). CONCLUSIONS: Intravenous iron sucrose is safe and effective for treating puerperal anemia and following gynecological surgery. The low incidence of serious side effects and the rapid recovery of hemoglobin levels make this a safe, effective drug for treating anemia.