Iron Status and Hematological Profile of Ghanaian Women with Fibroids

Abstract

Uterine leiomyomas are the most common gynecologic tumors and though mostly asymptomatic, they may present with heavy or abnormal uterine bleeding, pelvic pain or pressure, subfertility, and recurrent pregnancy loss. Heavy bleeding is often a reason to prescribe iron supplements in a bid to maintain normal hemoglobin levels. These hematinics are also sometimes prescribed for several months prior to surgery even though menorrhagia may not be the complaint. These women tend to stay on these supplements for long periods of time often without any laboratory investigation follow ups. Therefore a possibility of them developing iron overload exists especially if bleeding is not the presenting complaint. The aim of the present study was to determine the hematological profile of women with fibroids in Ghana. Between May 2005 and March 2009, in a case-control study of premenopausal Ghanaian women aged 20–40 years at Komfo Anokye Teaching Hospital,(KATH) Kumasi, the hematologic profile of women with fibroid in Ghana was studied. Two hundred women with confirmed uterine fibroids and two hundred women with non-observable fibroids as controls were recruited for the study. Results of the study showed that women with fibroids had higher red cell counts and red cell indices compared to women who had no fibroids. The mean Hematocrit (HCT), Mean Cell Hemoglobin (MCH), Mean Cell Hemoglobin Concentration (MCHC), and Red Blood Cell Count (RBC) were all significantly higher among patients compared to controls. Mean Cell Volume (MCV), Platelet (PLT) and Total White Blood Cell (WBC) count did not differ significantly between the two groups. Total serum iron (FE) was significantly higher while total iron binding capacity was significantly lower among patients compared to the control group. The results of the study revealed that the number of the patients who were on hematinics was significantly higher than that of the control group. Findings of this study show that women with fibroids in Ghana had higher hemoglobin and serum iron levels compared to their compatriots who did not have the condition. Prescription of iron supplements should therefore be done with care and only after reviewing their hematology laboratory results so as to prevent the development of iron overload among these women.