Iron deficiency conditions in pregnant women with chronic pyelonephritis

• E.N. Konovodova
• V.A. Burlev
• T.E. Karapetyan
• E.N. Prozorovskaya

Abstract

Objective. Optimization the diagnosis and treatment pregnant women with iron deficiency conditions and chronic pyelonephritis to reduce the incidence of obstetric and perinatal complications.

Subject and methods. A prospective cohort study was performed, which included 119 pregnant women; main group consisted of 52 patients with latent iron deficiency (LID) and chronic pyelonephritis, the comparison group – 67 women with chronic pyelonephritis without LID. various foundations of iron metabolism, acute-phase proteins change in these patients was studied and was analyzed the efficiency of selective prophylaxis LID.

Results. In pregnant women with chronic pyelonephritis and LID C-reactive protein is 2.5 times higher, and ferritin level is 2 times higher in contrast to those pregnant women with pyelonephritis without LID. Revealed that the production of erythropoietin in main group with LID before the treatment was reduced, and in comparison group was adequate. It is shown, that LID in pregnant has two clinical variants: «LID in pregnancy» and «LID in pregnant women with chronic pyelonephritis», when there are no clinical signs of iron deficiency, and the levels of the functional fund iron metabolism are at the lower limit of the normative values.

The incidence of gestational complications and adverse perinatal outcomes was significantly higher in patients with LID and chronic pyelonephritis in contrast to women with LID during pregnancy.

The efficiency of selective prophylaxis in pregnant women with LID is 93,5%, and in pregnant women with chronic pyelonephritis and LID – 70,8%. The absence of early treatment LID leads to the development of manifest iron deficiency in 69,4% of pregnant women with LID and in 92,8% of pregnant women with chronic pyelonephritis and LID.

Conclusion. The efficiency of selective prophylaxis by iron supplementation in pregnant women with LID significantly higher compared with that in pregnant women with LID and chronic pyelonephritis.

Early treatment LID in pregnant women with chronic pyelonephritis can prevent the development of manifest iron deficiency, and reduce the incidence of obstetric and neonatal complications.

Keywords:chronic pyelonephritis, iron deficiency conditions, anemia, pregnancy

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