Prevention and treatment of anemia in reproductive-aged women with gynecological diseases
The paper is devoted to a detailed description of the problems of anemia and iron deficiency (ID) in Russia and worldwide; it outlines the epidemiology of these conditions, gives the definitions of anemia and ID, and depicts disease stages. The clinical presentations and impact of anemia on the lives of reproductive-aged women are described in detail. Much attention is paid to the diagnosis and differential diagnosis of ID-associated anemia; various iron deficiency syndromes encountered in gynecology are depicted extensively. The description of a survey of 132 patients with various benign gynecological diseases presents the authors’ own data from a study of the frequency, characteristics, and pathogenesis of anemia in gynecological diseases. It is concluded that pathological blood loss is only one of the factors for anemia. Particular emphasis is placed on the study of hepcidin and the adequacy of production of endogenous erythropoietin, which has led to the conclusion that anemias are mixed in this category of patients and have signs of both iron deficiency anemia (IDA) and anemia of chronic disease. The recommendations of the World Health Organization (WHO) and the Russian Federation are given to prevent and treat anemia and ID. The authors describe the good effect of oral iron preparations in treating anemia in gynecological diseases, but emphasize that uterine fibroids are a factor that worsens a treatment response. The paper discusses the tolerability of oral iron therapy and recommendations for the most effective and safe treatment of IDA.Stuklov N.I., Levakov S.A., Sushinskaya T.V., Mitchenkova A.A., Kovalchuk M.O.
Keywords
iron deficiency
anemia
anemia in gynecology
anemia in women
recommendations for the treatment of anemia
hepcidin
erythropoietin
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Received 06.02.2020
Accepted 07.02.2020
About the Authors
Nikolay I. Stuklov, MD, professor of the Department of Hospital Therapy with courses of endocrinology, hematology and clinical laboratory diagnostics of the Peoples’ Friendship University of Russia, Moscow, head of the course of hematology; Senior Researcher, High-Dose Chemotherapy Unit with Bone Marrow Transplantation UnitP.A. Herzen - a branch of the Research Center of Radiology. Phone: +7 (916)811-95-51. Email: stuklovn@gmail.com
117198 Russia, Moscow, ul. Miklukho-Maklaya, d.6; 125284 Moscow, 2nd Botkinsky pr-d, d. 3.
Sergey A. Levakov, MD, professor, head of the department of obstetrics and gynecology at the Institute of Clinical Medicine named after N.V. Sklifosovsky Federal State Autonomous Educational Institution of Higher Education “First Moscow State Medical University named after I.M. Sechenov »Ministry of Health of Russia (Sechenov University). Phone: +7(925)506-31-44. E-mail: levakoff@yandex.ru
119048 Russia, Moscow, ul. Trubetskaya, d.8, p. 2.
Tatyana V. Sushinskaya, Candidate of Medical Sciences, Senior Researcher, Federal State Budgetary Institution Scientific Research Institute named after P.A. Herzen “Ministry of Health of the Russian Federation - a branch of FSBI” NIIRTS “Ministry of Health of the Russian Federation. Phone: +7 (925)195-74-89. E-mail: talgi65@yandex.ru
125284 Moscow, 2nd Botkinsky pr-d, d. 3.
Anna A. Mitchenkova, graduate student of the Department of Hospital Therapy with courses of endocrinology, hematology and clinical laboratory diagnostics of the Medical Institute of RUDN University. Phone: +7 (977)439-43-08. Email: enmitchell07 @ gmail.com
117198 Russia, Moscow, ul. Miklukho-Maklaya, d.6.
Maxim S. Kovalchuk, graduate student of the Department of Hospital Therapy with courses of endocrinology, hematology and clinical laboratory diagnostics of the Medical Institute of RUDN University. Phone: +7 (915)066-67-41. Email: hdcx93 @ gmail.com
117198 Russia, Moscow, ul. Miklukho-Maklaya, d.6.
For citation: Stuklov N.I., Levakov S.A., Sushinskaya T.V., Mitchenkova A.A., Kovalchuk M.O. Prevention and treatment of anemia in reproductive-aged women with gynecological diseases.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2020; 3: 218-26 (In Russian).
https://dx.doi.org/10.18565/aig.2020.3.218-226
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