Iron therapy in obstetrics and gynaecology: a review

Abstract

There are three problems in managing iron deficiency anaemia in child-bearing-age women: lack of awareness of the condition by both patient and clinician, inexperience in the diagnosis, and lack of familiarity with available oral and intravenous iron therapy. Iron deficiency is common in women, from menarche, through growth spurt in puberty, pregnancy, and postpartum, and until menopause. To screen for underlying iron deficiency, a haemoglobin cutoff for anaemia is used. Iron deficiency anaemia must be excluded for patients with haemoglobin level below the cutoff. Oral iron therapy is effective in treating iron deficiency anaemia. Low-dose alternate-day oral iron therapy is recommended (rather than daily iron dose). It is crucial to accompany oral iron therapy with vitamin C. Intravenous iron therapy, particularly with third-generation iron compounds, is safe, effective, and faster acting than oral iron therapy.

Enhanced recovery for gynaecological surgery: a review

“…Intravenous iron therapy can be considered when oral therapy fails or intolerable, or when near the time of operation. The newer generation of intravenous iron preparations has fewer severe adverse events and allows a larger dose of iron in a shorter infusion time 16 .…”

Intravenous iron therapy for menorrhagic patients with severe iron-deficiency anaemia: a retrospective cohort study

“…However, IV iron therapy may cause adverse drug reactions, especially anaphylaxis. Nonetheless, the second and third generations IV iron, such as iron sucrose, ferric carboxymaltose, and iron isomaltoside, have been associated with very low incidence of allergic reaction 7,9 , compared with firstgeneration IV iron therapy that uses an anaphylacticinducing Dextran conjugate 10,11 . Although proven to be safe, the wider use of IV iron therapy has been limited by the need for administration of multiple doses and/or multiple admissions, as well as complex dose calculation using the Ganzoni formula.…”