Iron deficiency in pregnant women suffering from chronic pyelonephritis

The aim of the study was the assessment of the peculiarities of iron metabolism in pregnant women suffering from chronic pyelonephritis. There was shown that pregnant females have signs of iron deficiency anemia which is more severe in women suffering from chronic pyelonephritis. The iIncidence of chronic pyelonephritis in women with signs of syderopenic syndrome is 35.0 %. There is discussed the pathogenesis of iron deficiency related to the renal dysfunction

Феномен взаимного отягощения при сочетании железодефицитной анемии и хронической урогенитальной инфекции у беременных

Метою дослідження була оцінка особливостей клінічного перебігу залізодефіцитної анемії у вагітних з хронічною урогенітальною інфекцією. Показано, що при сполученні хронічної урогенітальної інфекції та залізодефіцитної анемії реалізується феномен взаємного обтяження. У вагітних з сінтропіею хронічного пієлонефриту та сідеропенічних станів має місце внутрішньоклітинни метаболічний ацидоз на тлі активації перекисного окислення ліпідів. Наявність хронічного пієлонефриту призводила до поглиблення дефіциту сироваткового заліза до 8,8 ± 0,7 мкмоль / л при вмісті феритину на рівні 7,2 ± 0,2 мкг / лThe aim of the study was to evaluate the characteristics of clinical course of iron deficiency anemia in pregnant women with chronic urogenital infections. The survey was conducted at the Regional Clinical Maternity Hospital (Odessa, Ukriane) for 2005-2012 years. Study involved 100 pregnant women with signs of iron deficiency anemia. The total array was examined in three clinical groups: patients with verified urogenital infections (n = 50), patients with chronic pyelonephritis (n = 50). The average age of the patients was 27.1 ± 1.3 years. The control group consisted of 30 women with physiological pregnancy in the same age group. All women were examined according to the order of Ministry of Health of Ukraine from 03.11.2008 ¹ 62. It is shown that with a combination of chronic urogenital infection and iron deficiency anemia implemented phenomenon of the mutual encumbrance. The growth of microorganisms was observed in 78. 0 % of patients of I group, 66.0 % of II group and only in 6.7 % cases in the control group. Vaginitis and cervicitis with mixed bacterial etiology were found in 74.0 % of patients of the first group, and in 42.0 % of women – in the second group. Bacterial vaginosis was found a quarter of pregnant women with chronic pyelonephritis and iron-deficiency anemia and every third patient suffered from these conditions in the first group. In all groups examination noteworthy high frequency of vaginal dysbiosis, which is confirmed by the absence or low content (less than 1000 cfu / ml) of Lactobacilli. In pregnant women with chronic pyelonephritis and syntropiñ syderopenic states there is an intracellular metabolic acidosis in the background activation of lipid peroxidation. Thus, the activity of antioxidant enzymes in erythrocytes of women with sideropenicstates was changed. There was found that superoxydysmutaze activity in red blood cells in peripheral blood of pregnant women was decreased by an average of 15-20 % compared with the data obtained in the control group. The activity of glutathione peroxidase in red blood cells of women with chronic pyelonephritis increased by 1.5 folds. These changes were accompanied by an increase in lipid peroxidation activity, leading to accumulation of lipid peroxidation products in plasma. There is discussed the an association of this pathological condition with inflammatory diseases of the urinary tract in pregnant women suffering from iron deficiency anemia, which could lead to complicated pregnancy. In assessing hematological parameters revealed that among the surveyed pregnant women dominated light and subclinical forms of IDA. Most main group patients experienced a decline in hemoglobin and red blood cells. Initial level of iron in serum ranged from 5.3 to 13.3 mmol / l (9,7 ± 0,9 mmol / l – in the first group, 9,5 ± 1,1 mmol / l – in the second group. hemoglobin level ranged from 95 to 135 g / l (113,3 ± 3,5 g / l – in the first group, 110,5 ± 3,8 g / l – in the second group). Red blood cells count was averaged 3 5 1012 / l in pregnant and groups, 3,3 ± 0,2 1012 / l in the second group. Hence, patients with IDA hematological parameters practically did not depend on the pattern of chronic urogenital infection, but the variance of the indicators was slightly higher in pregnant women suffering from chronic pyelonephritis. The presence of chronic pyelonephritis led to a deepening deficit of serum iron to 8,8 ± 0,7 mmol / l in ferritin content at 7,2 ± 0,2 mg / l.Целью исследования была оценка особенностей клинического течения железодефицитной анемии у беременных с хронической урогенитальной инфекцией. Показано, что при сочетании хронической урогенитальной инфекции и железодефицитной анемии реализуется феномен взаимного отягощения. У беременных с синтропиею хронического пиелонефрита и сидеропенических состояний имеет место внутриклеточный метаболический ацидоз на фоне активации перекисного окисления липидов. Наличие хронического пиелонефрита приводило к углублению дефицита сывороточного железа до 8,8±0,7 мкмоль / л при содержании ферритина на уровне 7,2±0,2 мкг / л