A retrospective analysis of the women hospitalized and treated due to anemia caused by gynecological pathologies: the role of intravenous iron (ferric carboxymaltose) and blood transfusion in clinical practice.

BACKGROUND: Gynecological pathologies are an important cause of anemia in women. In this study, we aimed to evaluate women who had been hospitalized because of anemia (Hb level <10 g/dL) caused by gynecologic pathologies and treated with either intravenous iron (ferric carboxymaltose) or blood transfusion. METHODS: This retrospective cross-sectional study was performed in a tertiary care center. Women who were hospitalized with the diagnosis of anemia with Hb level<10 g/dL and abnormal uterine bleeding between March 2015- September 2017 in the gynecology clinic were enrolled in the study. Hemoglobin levels, hemoglobin changes, uterine pathology and treatment of patients were recorded and compared. RESULTS: One hundred and fifteen women received red blood cell transfusion and 100 women were treated with intravenous ferric carboxymaltose. The mean age of the women was 45.1±6.1 (22-57) years. Although the mean Hb levels were higher in the iv-iron replacement group at the end of the one month (P=0.001), the mean increase in Hb levels was similar between two treatment modalities (P=0.101). Among the anemic women who required surgery, iv iron replacement was the first choice in 75.9% of women; 34.1% received red blood cell transfusion in the preoperative period. CONCLUSIONS: Gynecological pathologies are a common cause of anemia in reproductive age women and intravenous carboxymaltose treatment is a safe and cheaper alternative of blood-transfusion in appropriate cases to elevate the Hb levels in the preoperative period.

Can we use as a marker the maternal serum levels of D-dimer and fibrinogen to predict intra uterin growth restriction?

OBJECTIVE: The purpose of the present study was to assess the effect of D-dimer and fibrinogen levels in maternal serum as a marker for detection of intrauterine growth restriction (IUGR). MATERIALS AND METHODS: Two hundred-thirty four pregnant women who get pregnancy follow-up and delivery in the tertiary hospital between January 2011 and December 2011 were admitted to the study. Pregnant women were divided into two groups; group-1: 117 pregnants complicated with IUGR and group-2: 117 healthy pregnants without IUGR as control. Serum D-dimer and fibrinogen levels of all pregnant women were measured in the third trimester. The levels of D-dimer and fibrinogen were compared between two groups. RESULTS: There is no significant difference between the groups for age, body mass index before pregnancy, smoking and gestational weeks (p>0.05). Gravidity, parity, number of children and maternal serum fibrinogen level were detected significantly different between the groups (p<0.001). D-dimer level was not significantly different between the groups (p=0.183), but fibrinogen level in group-1 was found higher than group-2. CONCLUSION: Serum fibrinogen level was found higher in pregnant women complicated with IUGR but D-dimer level was not different between the groups. Although serum D-dimer should not be used as a marker for detection of IUGR, serum fibrinogen may be used.

Serum brain natriuretic peptide and C-reactive protein levels in adolescent with polycystic ovary syndrome.

OBJECTIVE: Our primary aim was to investigate whether N-terminal pro-brain natriuretic peptide (NT-proBNP) increases in adolescent with polycystic ovary syndrome (PCOS) compared with healthy controls and secondary aim was to determine whether metabolic and hormonal differences exist between groups. METHODS: In this cross-sectional study, 25 adolescent patients with PCOS and 25 normal ovulatory control not suffering from PCOS were involved in the study. Fasting serum NT-proBNP, C-reactive protein (CRP), homocystein, insulin levels and biochemical and hormonal parameters were measured. RESULTS: Serum NT-proBNP was not significantly different in PCOS subjects (0.62 ± 0.80 vs 1.12 ± 1.51 ng/mL, p = 0.154). The mean serum fasting insulin levels (22.64 ± 10.51 vs 13.32 ± 3.97 mIU/mL, p = 0.001) and Homeostasis Model Assessment Insulin-Resistance Index (HOMA-IR) levels (5.16 ± 1.81 vs 2.97 ± 0.89, p = 0.001) were significantly high in the study group. The median serum CRP levels were not significantly different between groups (1 [1-12] vs 1 [1-19] g/dL, p = 0.286). CONCLUSIONS: The present study demonstrated that the levels of BNP, CRP and homocystein were not different in PCOS subjects. Serum insulin levels and HOMA-IR were significantly higher in PCOS subjects. Possible serum markers for PCOS-related metabolic abnormalities and cardiovascular events, may not present in the adolescent years.