Perioperative iron deficiency and anaemia in scheduled gynaecological surgery: An update based on findings from the PERIOPES and CARENFER studies: Iron deficiency in gynaecological surgery.

Résumé vulgarisé

Major gynaecological surgery is a significant risk factor for intra and postoperative blood loss. Effective iron deficiency (ID) and anaemia management is critical for ensuring patient safety. The aim of this update was to take an in-depth look at two recently published studies focusing on the assessment and management of ID and anaemia in subgroups of patients undergoing gynaecological surgery from the CARENFER PBM (2023) and PERIOPES (2023 and 2024) studies. Among the 6999 patients included in the three studies, 354 involved gynaecological procedures. Within this cohort, the prevalence of preoperative ID ranged from 70 % to 78 %, with 88 % considered absolute ID, while preoperative anaemia affected 28 %-59 % of women. Indeed, several gynaecological conditions that require surgery (e.g., uterine fibroids and gynaecological malignancies) are frequently associated with significant blood loss. Nonetheless, preoperative iron workup was only performed in 5 %-33 % of the patients. Furthermore, anaemia and/or ID were only treated in 12.5 %-24 % preoperatively and 25 % postoperatively. In conclusion, there seems to be a need to optimise perioperative ID and anaemia management in gynaecologic surgery by ensuring systematic preoperative screening and treatment for anaemia and/or ID and, wherever feasible, postponing surgery if restoration of the blood mass and iron stores is considered necessary prior to surgery.