The Efficacy of Recombinant Human Erythropoietin in Pregnant Patients with Iron Deficiency Anemia

Abstract
Background: Gestational anemia increases the incidence of maternal and fetal complications. Adjuvant recombinant human erythropoietin (rHuEPO) has been used in patients who refuse blood transfusions, have a low response to treatment with iron iron sucrose, have limited time before birth, or have other illnesses that complicate the anemia. We demonstrated that the use of adjuvant rHuEPO with iron sucrose reduces the anemia time period and is innocuous to the fetus.
Aim of the Study: To evaluate the efficacy of Recombinant Human Erythropoietin in the pregnant Patients with Iron Deficiency Anemia.
Patients and Methods: This is a prospective study includ-ing 70 pregnant women with iron deficiency anemia attending to the out-patient clinic of the department of Obstetric and Gynecology of Tanta University Hospital from June 2016 till June 2017. Divided into two groups, Group (A) Include (35) patients; received 200mg (10ml) iron sucrose intravenously twice weekly. Group (B) Include (35) patients; received 200 mg iron sucrose intravenously twice weekly and reco mbinant human erythropoietin (rhEPo) subcutaneous twice weekly.
Results: We found that group B shows higher level of serum iron than group A in second sample but differences still insignificant p-value 0.077. But group B shows lower level of serum ferritin than group A in the same sample and the difference is significant p-value 0.042 but it had higher level Hb level & Hematocrite & MCH and Reticulocytic count. The mean Hb level was 11g/dl ranging from (10.5 to 11.5) and 11.7g/dl ranging from (10.8 to 12.6) in group A&B respectively.Hemoglobin levels are raisied by up to 2.7g/dL and 3.2g/dL in group A&B respectively.
Conclusion: The use of adjuvant recombinant human erythropoietin can safely enhance the efficacy of iron sucrose in the treatment of gestational iron-deficiency anemia that did not respond to oral supplementation.