Breymann Christian
Department of Obstetrics and Gynaecology, University Hospital Zurich, Obstetric Research, Feto- Maternal Haematology Research Group, Zurich, Switzerland.
Semin Hematol. 2015 Oct;52(4):339-47. doi: 10.1053/j.seminhematol.2015.07.003. Epub 2015 Jul 10.
Anemia is a common problem in obstetrics and perinatal care. Any hemoglobin below 10.5 g/dL can be regarded as true anemia regardless of gestational age. Reasons for anemia in pregnancy are mainly nutritional deficiencies, parasitic and bacterial diseases, and inborn red blood cell disorders such as thalassemias. The main cause of anemia in obstetrics is iron deficiency, which has a worldwide prevalence between estimated 20%-80% and consists of a primarily female population. Stages of iron deficiency are depletion of iron stores, iron-deficient erythropoiesis without anemia, and iron deficiency anemia, the most pronounced form of iron deficiency. Pregnancy anemia can be aggravated by various conditions such as uterine or placental bleedings, gastrointestinal bleedings, and peripartum blood loss. In addition to the general consequences of anemia, there are specific risks during pregnancy for the mother and the fetus such as intrauterine growth retardation, prematurity, feto-placental miss ratio, and higher risk for peripartum blood transfusion. Besides the importance of prophylaxis of iron deficiency, the main therapy options for the treatment of pregnancy anemia are oral iron and intravenous iron preparations.
贫血是产科和围产期护理中的常见问题。无论孕周如何,血红蛋白低于10.5 g/dL都可被视为真正的贫血。孕期贫血的原因主要是营养缺乏、寄生虫和细菌疾病,以及诸如地中海贫血等先天性红细胞疾病。产科贫血的主要原因是缺铁,全球患病率估计在20%至80%之间,主要是女性人群。缺铁的阶段包括铁储存耗尽、无贫血的缺铁性红细胞生成,以及缺铁性贫血,这是缺铁最明显的形式。妊娠贫血可因各种情况而加重,如子宫或胎盘出血、胃肠道出血和围产期失血。除了贫血的一般后果外,孕期母亲和胎儿还存在特定风险,如宫内生长迟缓、早产、胎儿-胎盘比例失调,以及围产期输血风险增加。除了预防缺铁的重要性外,治疗妊娠贫血的主要治疗选择是口服铁剂和静脉铁剂制剂。