Iron is an important trace element in the human body. Insufficient iron elements often cause iron deficiency anemia . During pregnancy, pregnant women affect the absorption of iron due to pregnancy reactions, gastrointestinal motility and other factors. At the same time, the growth of the fetus will increase the demand for iron in the mother's body, which can easily cause iron deficiency anemia in pregnant women. Studies have shown that iron deficiency anemia has a higher prevalence among pregnant women. Iron deficiency anemia can cause serious harm to pregnant women and fetus.
Postpartum hemorrhage is a common complication of delivery in clinical practice and one of the main causes of maternal death. Studies have shown that anemia is one of the risk factors for postpartum bleeding. As iron deficiency anemia in pregnancy worsens, the incidence of postpartum bleeding will gradually increase.
1. Let’s take a look at what postpartum bleeding is!
- Postpartum bleeding refers to the bleeding volume of vaginal delivery within 24 hours after the fetus is delivered, and the bleeding volume of vaginal delivery is ≥ 500mL, and the bleeding volume of cesarean delivery is ≥ 1000mL;
- Severe postpartum bleeding refers to the bleeding volume of ≥ 1000ml within 24 hours after the fetus is delivered;
- Refractory postpartum bleeding refers to the inability to stop bleeding through constriction agents, continuous uterine massage or compression, and requires surgical surgery, intervention for treatment of or even uterine resection.
During pregnancy, the demand for iron is more than twice as high as before pregnancy. If pregnant mothers are accompanied by iron deficiency before pregnancy, the demand for iron after pregnancy should be increased more. If the iron intake is insufficient, pregnant mothers are prone to iron deficiency anemia.
2. Anemia in pregnant women affects maternal and infant health
Anemia in pregnant women can cause a decrease in resistance. Patients usually show symptoms such as palpitations , insomnia, dizziness, etc. In addition, pregnant women with anemia have reduced tolerance for delivery and surgery, and the risk of labor complications is increased, which not only affects the mother's recovery, but also may affect fetal health.
Iron is a necessary raw material for the survival of red blood cells and hemoglobin (Hb). The demand during pregnancy has increased significantly. Pregnant women need exogenous intake of iron to ensure the balance of iron circulation in the body. If iron intake is not paid attention to during pregnancy, the iron actually absorbed by pregnant women will be difficult to meet their needs, which may lead to a decrease in iron and gradually develop into iron deficiency anemia in the long run.
2. Iron supplementation treats iron deficiency anemia, which is conducive to improving hemoglobin levels and reducing postpartum bleeding
To meet the needs of fetal growth and development during pregnancy, the blood volume in pregnant women will increase, and the increase in blood volume will lead to blood dilution, causing the body's Hb concentration to decrease. Usually, the Hb concentration in the early stage of pregnancy begins to decline, and the Hb level can only be restored to the normal level after term.
study shows that compared with supplementing iron-containing diet and improving health awareness, supplementing iron agent according to the specification is a more effective way to improve Hb levels.
(1) There are mainly the following commonly used oral iron drugs:
① The first generation oral iron agent: ferrous sulfate
is inorganic iron, with a high iron content and a low price. It is a commonly used oral iron agent. However, its properties are unstable, absorbed in ionic form, are susceptible to interference from other components, have poor bioavailability, significant gastrointestinal irritation, and have a great rust smell.
②Second generation oral iron agent: ferrous lactate
ferrous lactate is a representative of the second generation oral iron agents of organic acid salts. Similar drugs also include ferrous citrate, ferrous succinate and ferrous fumarate . The common feature is that it is absorbed in the form of ions and is susceptible to interference from other components. Free Fe2+ leads to the production of endogenous free radicals and damages the cell membrane.
③The third generation of new organic iron: dextran iron
Research results show that iron dextran dispersed tablets have excellent therapeutic effect and high safety. Iron dextran is a third-generation oral iron agent. It uses iron complexes and dextran as the main components. It is a soluble iron element. After the drug enters the human body, iron dextran can effectively supplement the iron element needed in the patient's blood, which is conducive to alleviating clinical symptoms.
related studies show that iron dispersed dextran is highly soluble and is more easily absorbed by the human body. Different doses of medication are selected according to the degree of anemia, which can not only ensure the safety of medication, but also fully supplement the iron content, and the effect is obvious. To sum up, the clinical efficacy of dextran iron dispersed tablets in the treatment of pregnancy combined with iron deficiency anemia is accurate, can effectively improve the symptoms of anemia, reduce adverse pregnancy outcomes, and are highly safe, which is worthy of clinical promotion and application.
is affected by iron deficiency, and matrix metalloproteinase may be overexpressed, causing uterine smooth muscle contraction and inducing postpartum bleeding. In addition, the occurrence of iron deficiency anemia can also cause uterine ischemia and hypoxia, affect fetal nutrition and metabolism, and lead to fetal dysplasia.
Iron supplementation during pregnancy should be adopted to adopt an individual iron supplement strategy, master the appropriate time and reasonable dose, so as to reduce the incidence of hypertensive diseases during pregnancy, premature rupture of in , reduce organ dysfunction caused by anemia and low birth weight babies, etc. At the same time, the oxidative stress reaction caused by high doses of iron supplementation and excessive iron should also be avoided.
In summary, iron supplementation treatment for pregnant women with iron deficiency anemia during pregnancy is conducive to reducing the incidence of postpartum bleeding and bleeding, improving hemoglobin level and immune function, and reducing the incidence of adverse pregnancy outcomes.
Reference materials:
[1] Xu Kesu, Zhang Yan, Wang Yun, Zheng Xiaoyi. Effects of iron supplementation to prevent postpartum bleeding in pregnant women with iron deficiency anemia and its impact on hemoglobin levels [J]. Chinese Maternal and Child Health Research, 2022, 33(06): 62-66.
[2] Zhang Yu. Clinical efficacy and safety of iron dispersed tablets for treating pregnancy combined with iron deficiency anemia [J]. Journal of Clinical Rational Drug Use, 2020, 13(21): 127-128.
