Abnormal uterine bleeding and iron-deficiency anaemia. A pathogenetic rationale for choosing iron supplementation
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01.01.2018 |
Davydov A.
Dvoretskiy L.
Lebedev V.
Novruzova N.
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Voprosy Ginekologii, Akusherstva i Perinatologii |
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© 2018, Dynasty Publishing House. All rights resvered. Abnormal uterine bleeding (AUB) is a collective term uniting various disorders of the menstrual cycle of structural and nonstructural genesis. The causes of AUB are united in the acronym PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy and hyperplasia, Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not otherwise classified). Not infrequently, AUB (PALM), especially in case of associated severe menstrual bleeding, is accompanied by the development of iron-deficiency anaemia (IDA), the basic pathogenetic therapy for which is administration of iron preparations (IP). The choice of an IP should be guided not by the total amount of iron compounds, but by the amounts of elemental iron. A medical practitioner has two groups of IP at his or her disposal – iron salts (IS) and iron-containing complexes (ICC). A comparative analysis of these groups of IP proves the effectiveness of ICC: absence of the impact of food and medication on absorption, slow absorption rate, rapid elimination from blood serum to reserves, absence of oxidative stress, a comparatively rare frequency of side effects on the part of the gastrointestinal tract. Since in female patients with AUB IDA is conditioned by continuing iron losses that exceed the amount of dietary iron intake, administration of IP is obligatory. Additionally, not only the effectiveness but also the safety of an iron-polymaltose complex should be taken into consideration. The good tolerance of Maltofer and a convenient schedule of its dosing ensure a high compliance of patients to therapy.
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