Discussion on the detection of latent iron deficiency and iron deficiency anemia in gynecological practice and data on treatment outcomes

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OBJECTIVE

The aim of study was to analyze the detection of iron deficiency anemia (IDA) and latent iron deficiency (LID) in women with abnormal uterine bleeding against the background of uterine myoma uterus, endometrial hyperplasia and genital endometriosis and to study the effectiveness of therapy of patients with uterine bleeding and LID by the combined preparation Ferretab comp.

MATERIAL AND METHODS

The main reason of women’s referral to a medical institution was an abnormal uterine bleeding, therefore all the included in the investigation of patients with this complaint were classified according to the causes of bleeding: uterine myoma, endometrial hyperplasia or genital endometriosis. A local observational study in real clinical practice was carried out on 117 women with and without iron deficiency: 60 women with IDA, and 27 women with LID and 30 women in a comparison group. All women with IDA and LID were treated with iron fumarate/folic acid (Ferretab comp.). The effectiveness of therapy was assessed after 4 and 12 weeks according to dynamics of hemograms.

RESULTS

As a result of selection at the first stage 117 women aged 20 to 48 years old who fulfilled the inclusion/exclusion criteria were included in the study. Mean hemoglobin and ferritin levels in the study population in women with abnormal uterine bleeding, with bleeding on the background of uterine myoma, endometrial hyperplasia or endometriosis was 110.32±0.94 g/l for hemoglobin and 20.70±0.91 µg/l for ferritin. IDA was found in 51.3%, and LID in 23.1% of women without anemia but with iron deficiency. Blood counts of the comparison group of women (25.64%) were within normal limits. The mean hemoglobin and ferritin levels in the LID group increased after 4 weeks of therapy by 4 and 26.7% (p<0.001), while the 12-week therapy period it was 9 and 73.36% (p<0.001), respectively. Mean hemoglobin and ferritin levels in the IDA group after 4 weeks of therapy increased from the baseline by 9 and 66% (p<0.001) and after 12 weeks of therapy 23 and 288% (p<0.001) respectively. Therapy was continued in women in the IDA who didn’t reach target ferritin levels.

CONCLUSION

The use of Ferretab comp. is the drug of choice for patients with iron deficiency due to the presence of folic acid, which is a co-factor of iron, and also necessary for women of childbearing age, the dosage can be adjusted according to the patient’s needs and is well tolerated.

Keywords:

iron deficiency anemia

latent iron deficiency

iron fumarate

oral iron preparations

folic acid

uterine myoma

genital endometriosis

endometrial hyperplasia

Authors:

I.A. Kulikov

I.M. Sechenov First Moscow State Medical University;
V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

ORCID: 0000-0003-2499-4727

G.A. Gevorkyan

I.M. Sechenov First Moscow State Medical University;
V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

ORCID: 0000-0002-9788-2016

Received:

02.05.2023

Accepted:

06.05.2023

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