The Use of Iron Therapy for Patients With Anemia After Caesarean Section

The Value of Iron Treatment for Postoperative Obstetric Patients With Anemia: a Randomized Double Blind Controlled Trial

The purpose of this study is to determine whether oral or intravenous iron is effective in the treatment of anaemia (iron-poor blood) after caesarean section.

Anemia after caesarean section is often treated with iron therapy to ensure that the hemoglobin will return to normal more rapidly. Scientific evidence for this action is limited. Several studies, in which iron therapy was given after orthopaedic or cardiac surgery, show that after 6 to 10 weeks the hemoglobin was not significantly different between patients treated with oral preparations and patients treated with a placebo. These studies have not examined the hemoglobin level during the first few weeks after surgery including the quality of life analysis.

The purpose of this double blind randomized controlled trial therefore is to examine the effect of both oral iron therapy and intravenous iron therapy on hemoglobin level and on the quality of life during the first few weeks postcaesarean in patients with a moderate anemia.

Inclusion Criteria:

• Gynecological surgery
• Hb 5-7 mmol/L

Exclusion Criteria:

• Pregnancy
• Oncological operations
• Infections (PID)
• Diagnostic procedures: level 1 laparoscopies (diagnostic, sterilization, tubal testing; Hysteroscopies
• Smaller therapeutic procedures: large loop excision of transformation zone (LLETZ), Conization,
• Small vulvar / vaginal operations such as (cysts, labia correction)
• Endometrial ablation
• Legal incapacity
• The patient has used pre-operatively an iron preparation and / or blood transfusion or during the surgery
• Hematologic disorders
• Erythropoiesis-stimulating agents < 3months ago
• Myelosuppressive therapy in history
• Hepatitis
• HIV
• Alcohol abuses
• Not understanding Dutch
• Allergic reaction to iron therapy in past