Original Paper

Selective Use of Recombinant Human Erythropoietin in Pregnant Patients with Severe Anemia or Nonresponsive to Iron Sucrose Alone
Alexander Krafft, Gabriela Bencaiova, Christian Breymann

Feto-Maternal Hematology Group, Division of Obstetrics, Department of Obstetrics and Gynecology, University Hospital Zurich, Zurich, Switzerland

Address of Corresponding Author

Fetal Diagn Ther 2009;25:239-245 (DOI: 10.1159/000223441)

  Key Words

• Anemia
• Pregnancy
• Iron deficiency
• Iron sucrose
• Recombinant erythropoietin

  Abstract

Objective: To evaluate the effectiveness of a stepwise use of recombinant human erythropoietin (rhEPO) in pregnant patients with severe anemia or nonresponsive to intravenously administered iron only. Methods: All subjects had iron deficiency anemia, i.e., a hemoglobin (Hb) level <10.0 g/dl and ferritin ≤15 μg/l. Patients with an Hb level ≥9.0 g/dl and <10.0 g/dl received 200 mg iron sucrose intravenously twice weekly. If response to therapy was poor, patients additionally received 10,000 U rhEPO twice weekly. Patients with an Hb level <9.0 g/dl primarily received iron sucrose and rhEPO likewise. Results: Of the 84 patients, 59 had a baseline Hb level between 9.0 and 9.9 g/dl, of whom 32 responded poorly, thus receiving additional rhEPO. Twenty-five patients had a baseline Hb level <9.0 g/dl. The overall Hb level after therapy was 11.0 g/dl (±0.5, range 10.0–12.6 g/dl). Mean duration of therapy was 3.5 weeks (7 infusions). Conclusion: This study shows an effective treatment regimen for patients with various degrees of anemia in pregnancy. Iron sucrose is a safe and effective treatment option. In cases of severe iron deficiency anemia or poor response to parenteral iron therapy additional administration of rhEPO might be considered. However, the mechanism for not responding to intravenous iron therapy despite iron deficiency anemia still remains unclear to a large extent.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Alexander Krafft
Division of Obstetrics, Department of Obstetrics and Gynecology
University Hospital Zurich
CH–8091 Zurich (Switzerland)
Tel. +41 44 255 5148, Fax +41 44 255 4430, E-Mail alexander.krafft@usz.ch

  Article Information

Received: November 28, 2007
Accepted after revision: July 14, 2008
Published online: June 5, 2009
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 1, Number of References : 21