Forty to fifty-five-year-old women and iron deficiency: clinical considerations and quality of life.

Between the age of 40 and 55 years, women experience important changes in their lives. This period, which corresponds to the perimenopause for most women, is associated with the risk of iron deficiency anemia (IDA). The clinical presentation of anemia can be misleading, and the underlying cause, particularly bleeding, is frequently treated without concomitant iron prescription. Iron deficiency (ID) remains a social and economic burden in European countries. Underdiagnosed and undertreated, this problem has a strong negative impact on women's quality of life. The risk factors for ID are well known. The physician's role is essential in recognizing the symptoms, identifying the risk factors, detecting IDA by testing hemoglobin, and evaluating the degree of ID by measuring serum ferritin (SF). Iron therapy treats the anemia and restores iron stores, thus decreasing symptoms such as fatigue and restoring quality of life. Among the available forms of iron, evidence is in favor of ferrous sulfate in a slow release formulation, which is well-tolerated and results in good adherence, a key factor for efficacious supplementation.

Hysteroscopic resection of abnormally invasive placenta residuals.

OBJECTIVE: To present our experience in hysteroscopic removal of abnormally invasive placenta (AIP) residuals using bipolar energy. DESIGN: Case series. SETTING: University hospital. POPULATION: Sixteen patients with AIP residuals after 17 pregnancies. METHODS: Cases were identified by ultrasound, treated with hysteroscopic bipolar electrosurgery and oral contraceptives, and followed up by ultrasound or hysteroscopy. Nine subsequent pregnancies were described. MAIN OUTCOME MEASURES AND RESULTS: Complete removal of AIP residuals was achieved by hysteroscopic bipolar electrosurgery in all cases except one. No perioperative complications occurred. AIP residual recurred in one patient after a subsequent pregnancy and was successfully treated using the same procedure. CONCLUSIONS: AIP residual is a rare condition. Management by hysteroscopic resection using bipolar energy is safe and feasible.