APPROACHES TO THE DIAGNOSIS AND TREATMENT OF ANEMIA IN HEAVY MENSTRUAL BLEEDING
Keywords:
Iron-deficiency anemia, diagnosis, ferritin, transferrin, hepcidin, therapy, menstrual disorders, laboratory markers, prevention, reproductive health, pregnancy, treatment, hormonal therapy, personalized approachAbstract
The article examines modern approaches to the diagnosis and treatment of iron deficiency conditions caused by heavy menstrual bleeding. Particular attention is given to laboratory markers of iron deficiency, including ferritin, soluble transferrin receptors, and serum iron, as well as their role in the early detection of latent deficiency forms. Prospective therapeutic directions are discussed, including iron preparations, innovative approaches to hormonal balance normalization, and endometrial angiogenesis restoration. The impact of iron deficiency on reproductive health, including risks for the fetus and newborn, is highlighted. Preventive measures such as specialized diets, personalized treatment approaches, and the role of interdisciplinary collaboration in improving outcomes are considered. The article emphasizes the need to standardize clinical guidelines and raise awareness among healthcare providers and patients to reduce the prevalence of anemia.
References
Аномальные маточные кровотечения. Клинические рекомендации Российского общества акушеров-гинекологов (РОАГ). 2021
Баранов И. И., Сальникова И. А., Нестерова Л. А. Клинические рекомендации по диагностике и лечению железодефицитных состояний: взгляд из 2022 г //Акушерство и гинекология: Новости. Мнения. Обучения. – 2022. – Т. 10. – №. 2 (36). – С. 56-64.
Виноградова М. А. Анемия у женщин репродуктивного возраста: диагностика и коррекция железодефицита //Акушерство и гинекология. – 2019. – №. 6. – С. 140-145.
НАЦИОНАЛЬНЫЙ КЛИНИЧЕСКИЙ ПРОТОКОЛ «ВЕДЕНИЕ БЕРЕМЕННЫХ С ЖЕЛЕЗОДЕФИЦИТНОЙ АНЕМИЕЙ, 2024
Лукина Е. А., Деженкова А. В. Метаболизм железа в норме и при патологии //Клиническая онкогематология. Фундаментальные исследования и клиническая практика. – 2015. – Т. 8. – №. 4. – С. 355-361.
Романов А. Ю. и др. Профилактика железодефицитной анемии при беременности и лактации //Медицинский совет. – 2020. – №. 3. – С. 79-83.
Соломахина Н. И., Находнова Е. С., Ершов В. И. Анемия при хронической сердечной недостаточности: роль гепсидина как универсального регулятора метаболизма железа //Журнал сердечная недостаточность. – 2014. – Т. 15. – №. 4. – С. 254-260.
Тихомиров А. Л., Сарсания С. И. Проблема железодефицитной анемии у женщин: пути решения //РМЖ. Мать и дитя. – 2020. – Т. 3. – №. 1. – С. 44-50.
Третьякова О. С. Физиологическая роль железа в организме человека //Здоров’я Украïни. – 2013. – №. 1. – С. 14-18.
Чернуха Г. Е. Обильные менструальные кровотечения и анемия: проблема нарастает и требует решения //Гинекология. – 2024. – Т. 26. – №. 3. – С. 260-269.
Ших Е. В., Бриль Ю. А. Железодефицит: катастрофа для нейрогенеза //StatusPraesens. Гинекология, акушерство, бесплодный брак. – 2018. – №. 5. – С. 82-88.
Adam I., Salih Y., Hamdan H. Z. Association of maternal anemia and cesarean delivery: A systematic review and meta-analysis //Journal of Clinical Medicine. – 2023. – Т. 12. – №. 2. – С. 490.
Athe R. et al. Meta-analysis approach on iron fortification and its effect on pregnancy and its outcome through randomized, controlled trials //Journal of family medicine and primary care. – 2020. – Т. 9. – №. 2. – С. 513-519.
Ardic C. et al. Relationship between anaemia during pregnancy and preterm delivery //Journal of Obstetrics and Gynaecology. – 2019. – Т. 39. – №. 7. – С. 903-906.
Azami M. et al. The association between anemia and postpartum depression: A systematic review and meta-analysis //Caspian journal of internal medicine. – 2019. – Т. 10. – №. 2. – С. 115.
Bailey R. L., West Jr K. P., Black R. E. The epidemiology of global micronutrient deficiencies //Annals of nutrition and metabolism. – 2015. – Т. 66. – №. Suppl. 2. – С. 22-33.
Beckert R. H. et al. Maternal anemia and pregnancy outcomes: a population-based study //Journal of Perinatology. – 2019. – Т. 39. – №. 7. – С. 911-919.
Dugan C. et al. The misogyny of iron deficiency //Anaesthesia. – 2021. – Т. 76. – С. 56-62.
Georgieff M. K. The importance of iron deficiency in pregnancy on fetal, neonatal, and infant neurodevelopmental outcomes //International Journal of Gynecology & Obstetrics. – 2023. – Т. 162. – С. 83-88.
Finkelstein J. L. et al. Iron status and inflammation in women of reproductive age: a population-based biomarker survey and clinical study //Clinical nutrition ESPEN. – 2022. – Т. 49. – С. 483-494.
International Federation of Gynecology and Obstetrics. FIGO Statement: Iron deficiency and anaemia in women and girls. 2023. Available at: www.figo.org/resources/figo-statements/iron-deficiency-and-anaemiawomen-and-girls. Accessed: 01.07.2024
Janbek J. et al. A systematic literature review of the relation between iron status/anemia in pregnancy and offspring neurodevelopment //European Journal of Clinical Nutrition. – 2019. – Т. 73. – №. 12. – С. 1561-1578.
Krause A. et al. LEAP-1, a novel highly disulfide-bonded human peptide, exhibits antimicrobial activity //FEBS letters. – 2000. – Т. 480. – №. 2-3. – С. 147-150.
Munro M. G. et al. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions //International Journal of Gynecology & Obstetrics. – 2018. – Т. 143. – №. 3. – С. 393-408.
Munro M. G. et al. The relationship between heavy menstrual bleeding, iron deficiency, and iron deficiency anemia //American journal of obstetrics and gynecology. – 2023. – Т. 229. – №. 1. – С. 1-9.
Munro M. G. et al. Abnormal uterine bleeding: A well‐travelled path to iron deficiency and anemia //International Journal of Gynecology & Obstetrics. – 2020. – Т. 150. – №. 3. – С. 275-277.
Nemeth E. et al. Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein //Blood, The Journal of the American Society of Hematology. – 2003. – Т. 101. – №. 7. – С. 2461-2463.
Oh C., Keats E. C., Bhutta Z. A. Vitamin and mineral supplementation during pregnancy on maternal, birth, child health and development outcomes in low-and middle-income countries: a systematic review and meta-analysis //Nutrients. – 2020. – Т. 12. – №. 2. – С. 491.
Park C. H. et al. Hepcidin, a urinary antimicrobial peptide synthesized in the liver //Journal of biological chemistry. – 2001. – Т. 276. – №. 11. – С. 7806-7810.
Schoep M. E. et al. The impact of menstrual symptoms on everyday life: a survey among 42,879 women //American journal of obstetrics and gynecology. – 2019. – Т. 220. – №. 6. – С. 569. e1-569. e7.
Рахимов Н. М. и др. ЭФФЕКТИВНОСТЬ ЛЕЧЕНИЯ АСЦИТА ОБУСЛОВЛЕННЫЙ РЕЦИДИВОМ ПЛАТИНОРЕФРАКТЕРНОГО РАКА ЯИЧНИКА С ИСПОЛЬЗОВАНИЕМ МЕТРОНОМНОЙ ХИМИОТЕРАПИИ //ЖУРНАЛ РЕПРОДУКТИВНОГО ЗДОРОВЬЯ И УРО-НЕФРОЛОГИЧЕСКИХ ИССЛЕДОВАНИЙ. – 2024. – Т. 5. – №. 1.
Abdurakhmonov Jurabek , Rahimov Nodir , Shakhanova Shakhnoza . Modern view on ascite in ovarian cancer. Journal of Biomedicine and Practice . 2022, vol . 7, issue 4, pp . 130-139
Alimjanovich JR, Agababyan LR, Kamalov AI Prevention and Treatment of Postpartum Hemorrhage //CENTRAL ASIAN JOURNAL OF MEDICAL AND NATURAL SCIENCES. – 2021. – T. 2. – No. 4. – S. 204-209.
Rizaev Jasur , Rakhimov Nodir , Kodyrov Khamidullo , Shakhanova Shakhnoza . Study of prostate cancer death by regions of the republic of Uzbekistan.Journal of Biomedicine and Practice. 2022, vol . 7, issue 5, pp.202-210
Smith T. G., Robbins P. A., Ratcliffe P. J. The human side of hypoxia‐inducible factor //British journal of haematology. – 2008. – Т. 141. – №. 3. – С. 325-334.
Wang G. L. et al. Hypoxia-inducible factor 1 is a basic-helix-loop-helix-PAS heterodimer regulated by cellular O2 tension //Proceedings of the national academy of sciences. – 1995. – Т. 92. – №. 12. – С. 5510-5514.
WHO. The global prevalence of anaemia in 2011. Geneva: WHO, 2015
Williams A. M. et al. Data needed to respond appropriately to anemia when it is a public health problem //Annals of the New York Academy of Sciences. – 2019. – Т. 1450. – №. 1. – С. 268-280.
Wiegersma A. M. et al. Association of prenatal maternal anemia with neurodevelopmental disorders //JAMA psychiatry. – 2019. – Т. 76. – №. 12. – С. 1294-1304.
