A cross-sectional study was undertaken to evaluate if outpatient administration of intravenous iron sucrose complex (Venofer) was a sensible option in treating iron deficiency anaemia during pregnancy and puerperium. A total of 120 patients with iron deficiency anaemia were recruited from the Obstetric Day Care Clinic at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) over 18 months from March 2003 to August 2004. The main outcome measures were haemoglobin increment, patients’ compliance, adverse effects and saving from hospitalization fees. The pre-treatment haemoglobin (Hb) level was 8.5+0.85g/dl for the antenatal patient and 7.6+0.80 g/dl in the post-partum group. The mean post-treatment haemoglobin increment at day fourteenth was 3.52+0.75g/dl. One patient developed skin rash while another had low-grade pyrexia. Seven patients experienced mild metallic taste. There were no serious side effects or anaphylactic reactions. Ten patients (8.3%) did not complete their therapy - eight delivered before completion of treatment; another two defaulted following delivery. The average number of Venofer used was seven ampoules i.e. 700mg per person, most of them required three sessions to complete the course. Outpatient treatment allows each patient to save hospitalization fees of RM45 per day, which totalled up to RM135 for a 3-days ward stay. An estimation of RM16,200 hospitalization fees for the 120 patients was avoided during the study period. In conclusion, outpatient treatment of anaemia in pregnancy and post-partum period using Venofer was safe and feasible, with high patient compliant and cost-savings from hospitalization fees.
Intravenous Iron-Sucrose Complex for Treatment of Iron Deficiency Anaemia in Pregnancy - Experience in an Obstetric Day Care Clinic in a Tertiary Hospital
Abstrak
Satu kajian keratin rentas telah dilakukan untuk menilai kesesuaian rawatan anemia kekurangan besi semasa dan selepas kehamilan dengan menggunakan suntikan vena iron sucrose complex(Venofer)secara pesakit luar. Seramai 120 pesakit dari Klinik Rawatan Harian Obstetrik, Hospital Universiti Kebangsaan Malaysiatelah dikaji selama 18 bulan, diantara March 2003 hingga Ogos 2004. Hasil ukuran utama ialah kenaikan aras hemoglobin, pematuhan pesakit, kesan sampingan dan kejimatan dari yuran masuk wad. Sebelum menerima rawatan, aras hemoglobin ibu mengandung ialah 8.5+0.85g/dl dan 7.6+0.80 g/dl bagi ibu selepas bersalin. Min kenaikan aras hemoglobin selepas 14 hari merima rawatan ialah 3.52g/dl (2.9- 4.6g/dl).Hasil kajian menunjukkan seorang pesakit mengalami ruam kulit, dan seorang lagi mengalami demam panas ringan. Tujuh orang pesakit mengalami rasa metalik. Tiada kesan buruk yang serius atau reaksi anafilaktik berlaku. Sepuluh pesakit (8.3%) tidak meyempurnakan terapi – lapan orang ibu bersalin sebelum pelengkapan rawatan, dan dua orang ibu gagal menghadiri diri selepas bersalin. Secara purata, setiap orang pesakit menggunakan tujuh ampul Venofer iaitu 700mg, dan menjalani tempoh rawatan selama tiga hari. Rawatan sebagai pesakit luar mengelakkan dari tinggal di wad selama tiga hari dan dapat menjimatkan RM135 untuk rawatan wad kadar RM45 sehari. Dengan itu, sejumlah RM16,200 untuk bayaran masuk hospital dapat dielakkan oleh 120 orang pesakit ini. Sebagai kesimpulan, penggunaan Venofer untuk merawati anemia semasa dan selepas kehamilan sebagai pesakit luar adalah selamat, munasabah, menjimatkan dan mendapat pematuhan pesakit yang tinggi.
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