Iron deficiency states without anaemia are frequently found in countries with normal nutrition, and countries with chronic malnutrition have a high prevalence of people with iron deficiency anaemia. Anaemia and iron deficiency are among the top causes of morbidity and mortality throughout the world. Successful iron therapy depends on the correct diagnosis as well as the choice of effective iron preparations.
This updated edition deals with the diagnosis and treatment of iron deficiency states in females considering the current use of iron preparations and presents numerous obstetric and gynaecological case reports encountered in daily practice.
Spis treści
1. Introduction and basic knowledge 10
1.1. Gynaecological bleeding as a cause of iron deficiency and iron-deficiency anaemia 10
1.2. Pregnancy 10
1.3. Symptoms of iron deficiency and their treatment 10
1.4. Consequences in pregnancy 11
1.5. Diagnostic principles 11
1.5.1. Basic work-up 12
1.5.2. Differential diagnosis and additional investigations 12
1.6. Important differential diagnoses 15
1.7. Prevention and treatment of iron deficiency in non-pregnant women 15
1.8. Sustained iron therapy 17
1.9. Prevention and treatment of iron-deficiency anaemia in pregnancy 18
1.10. Prevention 18
1.11. Pharmacological supplementation 18
1.12. Treatment of iron-deficiency anaemia in pregnancy 19
1.13. Oral iron preparations 20
1.14. Parenteral iron preparations 21
1.15. Stimulation of erythropoiesis with recombinant erythropoietin (rh EPO) 23
1.16. Administration of allogeneic blood 24
1.17. Plasma products 25
1.18. Safety of blood products 26
1.19. Prescription of allogeneic blood 26
1.20. Principles of volume replacement 27
1.21. Maintenance of fluid balance 27
1.22. Summary of the most important principles for blood transfusion in obstetrics 27
2. Case reports in Gynaecology 31
2.1. A premenopausal woman who wishes to become pregnant 31
2.2. A perimenopausal patient with iron deficiency and heavy menstrual bleeding 34
2.3. Iron deficiency in the postmenopausal patient 36
2.4. Iron deficiency without anaemia (IDWA) and fatigue 38
2.5. Pre-operative anaemia prior to hysterectomy 40
2.6. Anaemia in a cancer patient 41
3. Case reports in Pregnancy and Postpartum 47
3.1. Iron deficiency without anaemia in pregnancy 47
3.2. Iron deficiency anaemia in pregnancy 48
3.3. Pre-operative anaemia in a Jehovah’s Witness 49
3.4. Anaemia in thalassaemia 51
3.5. Postpartum anaemia 56
4. Appendix 61
4.1. What are the risks of intravenous iron? 61
4.2. How should intravenous iron be administered? 61
4.3. Easy to remember – Ferritin and iron stores 62
4.4. Easy to remember – Blood loss and iron 63
4.5. Useful weblinks 63
Index 64
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