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Iron metabolism in pregnancy
Volume 66 Number 2
SELECTED ABSTRACTS
Klopper, Arnold, and Ventura., S.:
459
Iron Metabolism in Pregnancy, Brit. M. J. 2: 1251,
1951.
In 1,804 patients delivered by the obstetric service of the Hammersmith Hospital, 54 patients with hemoglobin below 10 Gm. per cent were observed. Eight, on re-examination, had borderline hemoglobin values and responded to oral iron. Two had mild cases of familial acholuric jaundice and another a congenital hemolytic anemia of obscure origin. :b'ive had eases of normocytic anemia with no complaints or symptoms, nor any signs of disease on examination. Their serum iron determinations were normal, but they had generally low iron-binding capacity, serum copper, and free erythrocyte protoporphyrin. 'rhey were considered to have sufficient iron available for hemopoiesis, but had a possible defect in iron utilization; thus, little or no benefit was to be expected from the administration of iron. The remaining 38 had classical cases of microcytic hypochromic anemia. Detailed studies of 9 of these showed their serum iron to be low, the iron·binding capacity to be increased, the serum copper high, and the free erythrocyte protoporphyrin increased. These values were then measured in 8 of the patients who received as treatment iron as Ferrivenin administered intravenously weekly in 100 mg. doses until the hemoglobin reached 10.2 Gm. Five hundred to 2,000 mg. of iron were required. The response was as might be expected with the general trend toward normal pregnant values, except in the case of protoporphyrin, which showed no general pattern in its response to iron. The patients all improved clinically. The effectiveness of intravenous Ferrivenin was further evaluated in 27 more patients with hypochromic anemia of pregnancy. From these data they calculate that during the last quarter of pregnancy for each 100 mg. of iron injected a rise of only 0.436 Gm. of hemoglobin can be expecteil (compared with 0.65 Gm. in the nonpregnant state) since about one-third of the iron injected is lost to the fetus. RoY W. BONSNES.
Magee, H. E., and Milligan, E. H.: 1\1. J. 2: 1307, 1951.
Haemoglobin Levels :Before and After Labour, Brit.
'rhe results of a survey of the hemoglobin values observed in 2,087 women during pregnancy and for a year or more following delivery in the area of Manchester, England, are reported in this paper. Hemoglobin was determined as alkaline hematin using a M. R. C. gray-wedge photometer. The average results during the antenatal period can be ilescribed by a curve which declines from 93 per cent (Haldane) at the eighth week to a minimum of about 81 per cent between the thirty-second and thirty-fourth weeks, then rises again to nearly 85 per cent at the thirty-ninth week. The average results observed during the postnatal period can be described by a straight line increasing from 85 per cent at the fourth to 90.5 per cent at the sixty-fifth postnatal week. These results tended to be more variable than those during the antenatal period. Those taking iron had higher levels throughout. The effects of iron medication were better the longer the iron was taken. With increasing parity there was a decrease in the mean concentration of hemoglobin, both ante partum and post partum. Low hemoglobin and clinically graded undernutrition did not necessarily parallel each other, though the incidence of clinically graded undernutrition increased with increasing parity, particularly during the antenatal period. No relationship was observed between hemoglobin leYels and s;ptolic blood ,pressure. RoY W. BONSNES. Benstea.d, N., and Theobald, G. W.: Brit. :M. J. 1: 407, 1952.
Iron and the "Physiological" Anemia of Pregnancy,
The range of initial hemoglobin values of 2,000 consecutive antenatal patients, pregnant for less than 17 weeks, who registered at the antenatal clinic of St. Luke's Maternity Hospital, Bradford, England, between January and October, 1950, are reported. SiKty per cent had values less than 12 Gm. per cent; 6.5 per cent less than 10 Gm. per cent. To test the effectiveness of iron administration during pregnancy in this population, small groups of these patients in the third decade and reasonably well matched as
SELECTED ABSTRACTS
Klopper, Arnold, and Ventura., S.:
459
Iron Metabolism in Pregnancy, Brit. M. J. 2: 1251,
1951.
In 1,804 patients delivered by the obstetric service of the Hammersmith Hospital, 54 patients with hemoglobin below 10 Gm. per cent were observed. Eight, on re-examination, had borderline hemoglobin values and responded to oral iron. Two had mild cases of familial acholuric jaundice and another a congenital hemolytic anemia of obscure origin. :b'ive had eases of normocytic anemia with no complaints or symptoms, nor any signs of disease on examination. Their serum iron determinations were normal, but they had generally low iron-binding capacity, serum copper, and free erythrocyte protoporphyrin. 'rhey were considered to have sufficient iron available for hemopoiesis, but had a possible defect in iron utilization; thus, little or no benefit was to be expected from the administration of iron. The remaining 38 had classical cases of microcytic hypochromic anemia. Detailed studies of 9 of these showed their serum iron to be low, the iron·binding capacity to be increased, the serum copper high, and the free erythrocyte protoporphyrin increased. These values were then measured in 8 of the patients who received as treatment iron as Ferrivenin administered intravenously weekly in 100 mg. doses until the hemoglobin reached 10.2 Gm. Five hundred to 2,000 mg. of iron were required. The response was as might be expected with the general trend toward normal pregnant values, except in the case of protoporphyrin, which showed no general pattern in its response to iron. The patients all improved clinically. The effectiveness of intravenous Ferrivenin was further evaluated in 27 more patients with hypochromic anemia of pregnancy. From these data they calculate that during the last quarter of pregnancy for each 100 mg. of iron injected a rise of only 0.436 Gm. of hemoglobin can be expecteil (compared with 0.65 Gm. in the nonpregnant state) since about one-third of the iron injected is lost to the fetus. RoY W. BONSNES.
Magee, H. E., and Milligan, E. H.: 1\1. J. 2: 1307, 1951.
Haemoglobin Levels :Before and After Labour, Brit.
'rhe results of a survey of the hemoglobin values observed in 2,087 women during pregnancy and for a year or more following delivery in the area of Manchester, England, are reported in this paper. Hemoglobin was determined as alkaline hematin using a M. R. C. gray-wedge photometer. The average results during the antenatal period can be ilescribed by a curve which declines from 93 per cent (Haldane) at the eighth week to a minimum of about 81 per cent between the thirty-second and thirty-fourth weeks, then rises again to nearly 85 per cent at the thirty-ninth week. The average results observed during the postnatal period can be described by a straight line increasing from 85 per cent at the fourth to 90.5 per cent at the sixty-fifth postnatal week. These results tended to be more variable than those during the antenatal period. Those taking iron had higher levels throughout. The effects of iron medication were better the longer the iron was taken. With increasing parity there was a decrease in the mean concentration of hemoglobin, both ante partum and post partum. Low hemoglobin and clinically graded undernutrition did not necessarily parallel each other, though the incidence of clinically graded undernutrition increased with increasing parity, particularly during the antenatal period. No relationship was observed between hemoglobin leYels and s;ptolic blood ,pressure. RoY W. BONSNES. Benstea.d, N., and Theobald, G. W.: Brit. :M. J. 1: 407, 1952.
Iron and the "Physiological" Anemia of Pregnancy,
The range of initial hemoglobin values of 2,000 consecutive antenatal patients, pregnant for less than 17 weeks, who registered at the antenatal clinic of St. Luke's Maternity Hospital, Bradford, England, between January and October, 1950, are reported. SiKty per cent had values less than 12 Gm. per cent; 6.5 per cent less than 10 Gm. per cent. To test the effectiveness of iron administration during pregnancy in this population, small groups of these patients in the third decade and reasonably well matched as