Diagnostik und Therapie der Eisenmangelanämie in Schwangerschaft und Wochenbett – eine Befragung geburtshilflicher Kliniken in der Schweiz

Abstract

PURPOSE: Iron-deficiency anaemia is one of the main causes of increased fetomaternal morbidity and mortality. Our aim was to assess the diagnostic and therapeutic routines for iron-deficiency anaemia in obstetrics in Switzerland. METHODS: A cross-sectional study was done using a highly standardized questionnaire to survey 64 obstetric hospitals in Switzerland. RESULTS: The response rate was ∼ 90 %. The survey revealed a high variation (5–30 %) in the estimates of the prevalence of this disorder. To initiate oral or intravenous iron substitution, the physicians use various cut-off values, resulting in both under- and over-supply. About half of the physicians reported a successful therapy for more than 70 % of their patients, 20 % even reported a success rate of more than 90 % after therapy. However, about 10 % of the physicians reported a success rate of less than 50 % after therapy. Most hospitals (84 %) use internal guidelines for the diagnosis and therapy of iron-deficiency anaemia. Nevertheless, most physicians (88 %) would support the development and implementation of an evidence-based national guideline. CONCLUSIONS: We present a first nationwide survey of the diagnosis and treatment of iron-deficiency anaemia in pregnancy and puerperium in a European country. The results reveal a high variation in the various diagnostic and therapeutic procedures and underline the need to develop a uniform standard for the management of anaemia in pregnancy. Almost all Swiss obstetricians also expressed a keen interest in such a standard. In 2007, such a uniform standard was established by an Expertenbrief of the Schweizer Gesellschaft fur Gynakologie und Geburtshilfe entitled “Diagnostik und Therapie der Eisenmangelanamie in der Schwangerschaft und postpartal”.