[Acute postpartum anaemia. Clinical practice and interest of intravenous iron]

Postpartum anaemia is a very frequent pathology concerning from 4% to 27% of patients. The purpose of this study was to estimate clinical practice in front of acute postpartum anaemia and to value a new treatment: intravenous iron.

Retrospective study over a period of 2 years (April 2001-March 2003) realised in the Department of Gynaecology and Obstetrics of Belfort Regional Hospital. Two hundred and seventeen patients were included (5% of deliveries in the same period) with immediate postpartum period haemoglobin <8 g/dl. Two groups were individualised according to the availability or not of an intravenous iron therapy. Clinical and biologic elements concerning deliveries were analysed.

Average haemoglobin values, from delivery to 48 h after it, were 5.81 g/dl for blood-transfused patients, 6.88 g/dl for intravenous iron treated patients and 7.43 g/dl for oral iron treated patients. Fifteen patients were transfused during the year before the launch of intravenous iron as a possible therapy and only five patients the next year. The benefit of haemoglobin values with an intravenous iron therapy was 1.9 g/dl on 7 days and 3.1 g/dl on 14 days.

These results suggest a real efficiency of intravenous iron therapy for acute postpartum anaemia (haemoglobin values <8 g/dl) with a good tolerance. Patients with haemoglobin values <7 g/dl treated by intravenous iron tend to show that some blood transfusions would be thereby avoided even though blood transfusion remains the urgency treatment.