A rare occurrence of intrauterine death following an allergic reaction to iron sucrose

Abstract

During pregnancy, iron-deficiency anemia if untreated can affect the mother and child and hence iron is supplemented. Intolerance to oral iron therapy and malabsorption are common indications for parenteral iron therapy. The regularly used intravenous iron preparations are iron sucrose, sodium ferric gluconate, and iron dextran, of which iron sucrose has a satisfactory safety profile. We report a case of iron sucrose causing rare reaction with generalized edema in the mother, which was followed by intrauterine death. The oxidative stress due to immune-mediated mechanisms or adjuvant used in iron sucrose could cause mild rashes to severe anaphylactic reactions. This case report warns us toward the use of parenteral iron preparations in pregnant women, as one of the safe formulations could lead to an unusual fatal outcome in the fetus.

Keywords: Anemia; intrauterine death; iron sucrose; pregnancy.

Figure 1

Ultrasound abdomen done at 28 weeks of gestation showing signs of fetal death. The arrow shows Spalding's sign (the overlap of fetal skull bones caused by collapse of the fetal brain)