Simeon C. Amadi

Rivers State University Teaching Hospital, Nigeria

Title: Evaluation of serial serum ferritin, serial packed cell volume and the determination of response to oral iron therapy among pregnant women with iron deficiency in a sub-urban tertiary hospital in Nigeria


Anaemia in pregnancy is more prevalent in the developing countries and is associated with increased maternal and foetal morbidity and mortality. Iron deficiency (ID) is the most common cause of anaemia in pregnancy. Inadequate iron intake can lead to varying degrees of deficiency; from low iron stores to early iron deficiency and iron deficiency anaemia. (IDA) Serum ferritin is the single best non-invasive test to ascertain Iron stores. The study aimed to evaluate the serial serum ferritin and packed cell volume (PCV) amongst antenatal women with iron deficiency in Irrua Specialist Teaching Hospital in determining their response to oral iron therapy. 
This was a longitudinal study from January 2016 to December 2016 in which 742 pregnant women in their first trimester at booking were screened for ID and 345 consecutive women with ID were followed-up to 36 weeks. The PCV of the booking women were also assayed. The women were commenced on the routine 200mg ferrous sulphate Iron formulation. The serum ferritin and the packed cell volume were repeated at 24-26 weeks and 34-36 weeks. Serum ferritin was measured using a human Ferritin SA ELISA Kit. The microhematocrit centrifuge/microhematocrit reader were used to determine the PCV. Data obtained from the study were analysed using the IBM Statistical Package for Scientific Solutions (SPSS) version 20.0 software. 
The prevalence of ID was 46.5%. Out of the 345 women with ID recruited for the study, only 17% had normal PCV (? 30%) in the first trimester. Then, 57.9% had normal PCV in the second trimester and 73.9% had normal PCV in the third trimester following supplementation with oral iron. In the third trimester, only 1.7% of the participants had <30ng/ml of ferritin (below normal). The difference between the first trimester ferritin level and the second and the third trimester ferritin levels were statistically significant. CONCLUSION: Iron deficiency and IDA were prevalent in our setting. There was marked improvement in the PCV and serum ferritin level across the trimesters with iron supplementation. Hence the routine iron therapy for our pregnant population was helpful.


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