Shishii Miho, Hyuga Shunsuke, Miyamoto Masashi, Terada Noriko, Fujinaka Waso
Department of Anesthesiology and Intensive Care, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, JPN.
Department of Obstetric Anesthesia, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, Hiroshima, JPN.
Cureus. 2024 Jul 11;16(7):e64355. doi: 10.7759/cureus.64355. eCollection 2024 Jul.
Iron deficiency anemia is the most common cause of anemia in pregnancy. Therefore, iron administration is recommended for treatment. Iron deficiency anemia during pregnancy does not always result in microcytic anemia. Thus, iron may continue to be administered as diagnostic therapy, even in patients with normocytic anemia. In the present case, although the patient had normocytic anemia, repeated intravenous iron administration resulted in liver dysfunction due to secondary iron overload, which required intensive care. In pregnant women with perinatal hepatic dysfunction, iron overload secondary to iron therapy administered to correct anemia during pregnancy should be considered in the differential diagnosis.
缺铁性贫血是孕期贫血最常见的原因。因此,建议给予铁剂治疗。孕期缺铁性贫血并不总是导致小细胞贫血。因此,即使是正细胞性贫血的患者,铁剂也可作为诊断性治疗持续使用。在本病例中,尽管患者为正细胞性贫血,但反复静脉补铁导致继发性铁过载,进而引起肝功能障碍,这需要重症监护。对于围产期肝功能障碍的孕妇,在鉴别诊断时应考虑孕期为纠正贫血而进行铁剂治疗继发的铁过载。