Iron deficiency conditions in gynaecology: Effective management of perioperative anaemia

Abstract

Iron deficiency anaemia is one of the most common diseases among women, and is most often caused by posthemorrhagic conditions. Gynaecological diseases requiring surgical treatment play a determinant role in the genesis of heavy iron loss in women. Anaemia can prevent from the timely surgery, and failure to eliminate local causes of blood loss can deteriorate the patients’ condition and quality of life. Anaemia is currently regarded as a serious risk factor for the outcomes of surgical treatment, which can and should be eliminated. At the same time, substitution transfusion that was previously often used to manage anaemia in less time is not only ineffective and has a temporary effect, but can itself cause such serious complications as haemolysis, infection, anaphylaxis. Therefore, it is recommended to apply an approach that combines diagnosis and treatment of anaemia, reduces blood loss and improves the general condition of patients. This approach can lead to about 40% reduction in the incidence of complications. The review summarizes the main features of iron deficiency anaemia in gynaecology and the most effective approaches to therapy. Early onset of modern oral ferrotherapy allows to assign treatment courses of required duration without side effects and prevents severe iron deficiency. Parenteral administration of iron carboxymaltose has significantly reduced the duration of treatment and improved its effectiveness in severe recurrent and perioperative anaemia. Timely management of anaemia allows not only to perform surgical intervention in time, when indicated, but also to reduce the likelihood of complications and improve the women’s quality of life.