Affiliation:
1. Birth Centre of City Clinical Hospital No. 40
Abstract
Introduction. According to domestic and foreign authors, most women have a greater or lesser level of iron deficiency by the end of pregnancy and deplete their depot iron reserves, and anaemia develops by the time of delivery. Erythrocyte destruction occurs in presence of acute inflammation, including that caused by COVID-19, which leads to a chaotic distribution of iron within tissues and a pronounced loss of its reserves and aggravation of the existing deficiency. Due to overlapping changes with underlying novel coronavirus infection, iron deficiency creates favourable conditions for the development of infectious and inflammatory complications in the postpartum period by the time of delivery.Aim. To assess the features of the postpartum period and hematological status in puerperas with post-COVID anemia, who receive the combination therapy including an anti-anemic ferrous iron drug.Materials and methods. The prospective study included 30 puerperas (treatment group) in the postpartum period, who had a coronavirus infection with a mild degree of IDA during the gestation period. Group 2 (comparison group) included 15 puerperas with mild IDA, who did not have a coronavirus infection during the gestation period. Group 3 (control group) included 15 conditionally healthy puerperas, who had no novel coronavirus infection and did not suffer from IDA during the gestation period.Results and discussion. The puerperas, who had COVID-19 in pregnancy, developed infectious and inflammatory diseases significantly more often in the postpartum period. Subinvolution of the uterus, postpartum endometritis and thyroiditis, disruption of perineal stitches and seromas (hematomas) of the suture after cesarean section, vaginal dysbiotic conditions occurred significantly more often in puerperas with IDA, who came through coronavirus infection, than in women from the comparison group and control group (SBI index, p < 0.05).Conclusion. Women who had COVID-19 in pregnancy should be spinned off into a separate infectious risk group due to the possibility of postpartum complications and timely management of concomitant pathologies and appropriate treatment of IDA.
Reference37 articles.
1. Tyutyunnik V.L., Vinogradova M.A., Kan N.E. Diagnosis, prevention and therapy of iron deficiency conditions in pregnant women: obstetrician-gynecologist and hematologist’s views. Akusherstvo i Ginekologiya (Russian Federation). 2021;(3):10–16. (In Russ.) Available at: https://aig-journal.ru/articles/DIAGNOSTIKA-PROFILAKTIKA-I-TERAPIYa-JELEZODEFICITNYHSOSTOYaNII-U-BEREMENNYH-VZGLYaD-AKUShERA-GINEKOLOGA-IGEMATOLOGA.html.
2. Yakunina N.A., Zaydieva Z.S. Iron deficiency in pregnant women: a problem appears especially relevant today. Meditsinskiy Sovet. 2012;(7):56–60. (In Russ.) Available at: https://cyberleninka.ru/article/n/defitsit-zheleza-uberemennyh-problema-ne-teryayuschaya-svoey-aktualnosti.
3. Napolitano M., Dolce A., Celenza G., Grandone E., Perilli M.G., Siragusa S. et al. Iron-dependent erythropoiesis in women with excessive menstrual blood loss and women with normal menses. Ann Hematol. 2014;93(4):557–563. https://www.doi.org/10.1007/s00277-013-1901-3.
4. Gromova O.A., Torshin I.Yu., Shapovalova Yu.O., Kurtser M.A., Chuchalin A.G. COVID-19 and iron deficiency anemia: relationships of pathogenesis and therapy. Obstetrics, Gynecology and Reproduction. 2020;14(5):644–655. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.179.
5. Adamyan L.V., Aznaurova Ya.B., Filippov O.S. COVID-19 and women’s health (literature review). Russian Journal of Human Reproduction. 2020;26(2):6–17. (In Russ.) https://doi.org/10.17116/repro2020260216.