[The 'Anemia in the midwife practice' standard issued by the Royal Dutch Organisation of Midwives: a risk of not recognizing iron deficiency and hemoglobinopathy]. / De standaard 'Anemie in de eerstelijns verloskundige praktijk' van de Koninklijke Nederlandse Organisatie van Verloskundigen (KNOV): risico voor het niet onderkennen van ijzergebrek en hemoglobinopathie.
Ned Tijdschr Geneeskd
; 146(10): 457-9, 2002 Mar 09.
Article
em Nl
| MEDLINE
| ID: mdl-11913108
ABSTRACT
The standard entitled 'Anaemia in the midwife practice' issued by the Royal Dutch Organisation of Midwives presumes that the only reason for iron therapy in pregnancy is the prevention of adverse pregnancy outcome due to a low haemoglobin level. Pregnant women are screened for iron deficiency anaemia by means of sequential testing of haemoglobin and mean corpuscular volume (MCV). As a result only 10% of pregnant women will receive iron supplements. This practice will lead to a deterioration in the already low iron status of Dutch premenopausal women. As the haemoglobin reference values are lower than hitherto used, only severely anaemic women will be detected. Due to the low diagnostic accuracy of the MCV test the subsequent selection will be an arbitrary one. The standard sets the cut-off values for haemoglobin in black women at an even lower level, which will reduce the number of haemoglobinopathies detected in the immigrant population. The non-carriers in this group will run an increased risk of adverse pregnancy outcome if these cut-off values are used. We are strongly in favour of the measurement of haemoglobin, erythrocyte indices and ferritin in early pregnancy. In this way, iron deficiency, iron deficiency anaemia, anaemia due to other causes and haemoglobinopathies, the latter highly underestimated in the standard, can be detected.
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01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hemoglobinas
/
Anemia Ferropriva
/
Hemoglobinopatias
/
Ferro
/
Tocologia
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
Nl
Revista:
Ned Tijdschr Geneeskd
Ano de publicação:
2002
Tipo de documento:
Article