Parental iron (IV Iron Sucrose) may be considered as the first line of management in pregnant women who are detected to be anemic late in pregnancy or in whom compliance is likely to be low. For the severe anemia (Hb 5.0-6.9g/dl) the treatment will be done using IV Iron Sucrose Intravenous iron therapy having the advantage of less gastro intestinal (GI) side effects and speedy recovery of Hb than oral iron therapy
Parenteral iron therapy plays important role when there is need of rapid repletion of iron stores. The most common iron preparation which is used for anemia in pregnancy was iron sucrose complex. (ICS). It is not associated with anaphylaxis and other adverse reaction but this needs multiple doses and prolonged infusion time. That is the main disadvantage of iron sucrose.
The new addition in i.v. iron preparations is Ferric Carboxymaltose (FCM), which is a dextran free type I iron complex. IV ferric carboxymaltose (FCM) has a neutral pH (5.0‑7.0) and physiological osmolality, because of this it is possible to administer in higher single doses over shorter time periods (single dose up to 1000 mg over 15 min) than other parenteral preparations. Also it does not contain dextran; therefore, the risk of anaphylaxis or serious hypersensitivity reactions is very low.