Anémie a její léčba perorálnímiantianemiky u žen v poporodním období

Anaemia and its Treatment with Oral AntianaemicDrugs in Women during the Post-partum Period

Summary:
The prevalence of anaemia during pregnancy and post partum is according to theliterature and many years clinical experience high. In the submitted work we investigated theincidence of sideropenic anaemia in women during the first three months after a spontaneousdelivery, changes of clinical and laboratory indicators of anaemia during this period and thepossible effect exerted by administration of iron and iron plus folic acid resp.Ninety pregnant women in the 35th to 39th week of pregnancy were at random divided into threeequally sized groups and the following were assessed: haemogram, indicators of iron reserves,serum concentrations of folic acid, vitamin B12, erythropoetin and soluble transferrin receptor,liver tests, total protein + electrophoresis, acute stage proteins. In the first group (T) the womenwere given, starting on the 4th day after delivery 1 tablet of Tardyferon per day for two months.To the second group (F) for an equal period 1 tablet of Tardyferon Fol per day was administered.Women in the control group (K) had no medication. In the investigation women with medium andsevere pregnancy anaemia were not included nor women taking during pregnancy or previouslyiron preparations or those treated in the past by blood transfusion. After spontaneous delivery(women who had Caesarean section or forceps delivery were eliminated from the study) thewomen were subjected to the same examinations as before delivery. These examinations weremade on the fourth day after delivery and then after monthly intervals for a period of threemonths. At the same time the subjective condition of the mothers was evaluated after delivery,focused on the development of symptoms typical for anaemia and the possible effect of administe-red treatment. The investigation was completed by 60 women. During treatment no allergic orother serious side-reactions to the administered drugs calling for discontinuation of treatmentwere recorded.The results of the investigation proved that laboratory and clinical indicators of post-partumanaemia reached more quickly normal values in women treated with iron preparations. Theauthors did not detect a single and supreme marker of sideropenic anaemia in the early post-par-tum period. This is one of the reasons why the authors recommend iron administration to allwomen after spontaneous delivery. In the authors’ opinion examination of the blood count on thefourth day and assessment of the serum ferritin concentration one month after a spontaneousdelivery in selected mothers (e.g. after an above average peripartal blood loss) is desirable. Addi-tion of folic acid to iron is of no special value during the post-partum period. Iron substitution inwomen after spontaneous delivery should be, with regard to the long persisting sideropenia,administered at least for three months. The dose of 80 mg elemental iron per day is sufficient formild or medium post-partum anaemia. Addition of mucoprotease and ascorbic acid to iron prepa-rations is useful because it increases the compliance of the patients and thus also its effective-ness. The preparation Tardyferon meets the above criteria and is therefore a good choice for thetreatment of post-partum anaemia.

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