{"title":"妊娠期和产后缺铁性贫血的诊断和治疗","authors":"C. Breymann, C. Honegger, I. Hоsli, D. Surbek","doi":"10.18370/2309-4117.2023.68.70-74","DOIUrl":null,"url":null,"abstract":"Iron deficiency occurs frequently in pregnancy and can be diagnosed by serum ferritin-level measurement (threshold value < 30 μg/L). Screening for iron-deficiency anemia is recommended in every pregnant women, and should be done by serum ferritin-level screening in the first trimester and regular hemoglobin checks at least once per trimester. In the case of iron deficiency with or without anaemia in pregnancy, oral iron therapy should be given as first-line treatment. In the case of severe iron-deficiency anemia, intolerance of oral iron, lack of response to oral iron, or in the case of a clinical need for rapid and efficient treatment of anaemia (e.g., advanced pregnancy), intravenous iron therapy should be administered. In the postpartum period, oral iron therapy should be administered for mild iron-deficiency anemia (haemorrhagic anemia), and intravenous iron therapy for moderately severe-to-severe anemia (Hb < 95 g/L). If there is an indication for intravenous iron therapy in pregnancy or postpartum, ironcontaining drugs which have been studied in well-controlled clinical trials in pregnancy and postpartum such as ferric carboxymaltose must be preferred for safety reasons. While anaphylactic reactions are extremely rare with non-dextrane products, close surveillance during administration is recommended for all intravenous iron products.","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"139 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnosis and treatment of iron‑deficiency anaemia in pregnancy and postpartum\",\"authors\":\"C. Breymann, C. Honegger, I. Hоsli, D. Surbek\",\"doi\":\"10.18370/2309-4117.2023.68.70-74\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Iron deficiency occurs frequently in pregnancy and can be diagnosed by serum ferritin-level measurement (threshold value < 30 μg/L). Screening for iron-deficiency anemia is recommended in every pregnant women, and should be done by serum ferritin-level screening in the first trimester and regular hemoglobin checks at least once per trimester. In the case of iron deficiency with or without anaemia in pregnancy, oral iron therapy should be given as first-line treatment. In the case of severe iron-deficiency anemia, intolerance of oral iron, lack of response to oral iron, or in the case of a clinical need for rapid and efficient treatment of anaemia (e.g., advanced pregnancy), intravenous iron therapy should be administered. In the postpartum period, oral iron therapy should be administered for mild iron-deficiency anemia (haemorrhagic anemia), and intravenous iron therapy for moderately severe-to-severe anemia (Hb < 95 g/L). If there is an indication for intravenous iron therapy in pregnancy or postpartum, ironcontaining drugs which have been studied in well-controlled clinical trials in pregnancy and postpartum such as ferric carboxymaltose must be preferred for safety reasons. While anaphylactic reactions are extremely rare with non-dextrane products, close surveillance during administration is recommended for all intravenous iron products.\",\"PeriodicalId\":21103,\"journal\":{\"name\":\"Reproductive Endocrinology\",\"volume\":\"139 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-06-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reproductive Endocrinology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18370/2309-4117.2023.68.70-74\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive Endocrinology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18370/2309-4117.2023.68.70-74","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
缺铁在妊娠期经常发生,可通过血清铁蛋白水平测定(阈值<30μg / L)。建议对所有孕妇进行缺铁性贫血筛查,并应在妊娠早期进行血清铁蛋白水平筛查,每三个月至少进行一次血红蛋白常规检查。在缺铁伴或不伴妊娠贫血的情况下,口服铁治疗应作为一线治疗。在严重缺铁性贫血、口服铁不耐受、对口服铁缺乏反应的情况下,或在临床需要快速有效治疗贫血的情况下(例如,晚期妊娠),应给予静脉注射铁治疗。在产后,轻度缺铁性贫血(出血性贫血)应口服铁治疗,中重度至重度贫血(Hb <95 g / L)。如果有妊娠期或产后静脉补铁的指征,则出于安全考虑,必须优先使用经妊娠期和产后临床对照良好的含铁药物,如三羧基麦芽糖铁。虽然非右旋糖酐产品的过敏反应极为罕见,但建议所有静脉注射铁产品在给药期间密切监测。
Diagnosis and treatment of iron‑deficiency anaemia in pregnancy and postpartum
Iron deficiency occurs frequently in pregnancy and can be diagnosed by serum ferritin-level measurement (threshold value < 30 μg/L). Screening for iron-deficiency anemia is recommended in every pregnant women, and should be done by serum ferritin-level screening in the first trimester and regular hemoglobin checks at least once per trimester. In the case of iron deficiency with or without anaemia in pregnancy, oral iron therapy should be given as first-line treatment. In the case of severe iron-deficiency anemia, intolerance of oral iron, lack of response to oral iron, or in the case of a clinical need for rapid and efficient treatment of anaemia (e.g., advanced pregnancy), intravenous iron therapy should be administered. In the postpartum period, oral iron therapy should be administered for mild iron-deficiency anemia (haemorrhagic anemia), and intravenous iron therapy for moderately severe-to-severe anemia (Hb < 95 g/L). If there is an indication for intravenous iron therapy in pregnancy or postpartum, ironcontaining drugs which have been studied in well-controlled clinical trials in pregnancy and postpartum such as ferric carboxymaltose must be preferred for safety reasons. While anaphylactic reactions are extremely rare with non-dextrane products, close surveillance during administration is recommended for all intravenous iron products.