Megaloblastic Anemia




Megaloblastic Anemia
Megaloblastic Anemia




Megaloblastic Anemia


Is the second most common nutritional anaemia seen during pregnancy?

Folate deficiency is the cause of the deficiency in Vit B12 must be considered.

Folate:

Folic acid, a water-soluble vitamin is widely available in the diet. Folate is absorbed in the proximal jejunum. pancreatic conjugases reduce folate to monoglutamate before its absorption conjugases activity is reduced by :

1. Anticonvulsants.

2. Oral contraceptive.

3. Alcohol.

4. Sulfa drugs.

Because adequate folate intake before and during the first weeks of pregnancy may reduce the occurrence of neural tube defects, all women considering become pregnant should consume 400 mcg/day of folate.

Vitamin B 12:

Abundantly available in diet bond to animal protein, its absorption requires HCL and pepsin to free the cobalamin molecule from protein most of the Vit B 12 is stored in the liver and most people have a 2-3 years store available.

Diagnosis of anaemia:

- Anaemia is not a diagnosis, but rather than assign as fever.

- Is the patient anaemic?

- What is the morphology of anaemia? CBC and reticulocyte are helpful.

- What is the mechanism of anaemia?

- Is there underlying disease?

History:

- Family history.

- History of tonics.

-History of GI bleeding

- Exposure to oxidant drugs ( risk of G6PD ) e.g. sulfonamides, PASA.

- Peripheral blood smear.

- Serum iron value ( less than 30 mcg /dl indicate IDA).

- The gold standard to determined iron stores is a bone marrow biopsy, which is rarely indicated in pregnancy patients.

Treatment:

- Preventable by routine use of iron supplementation. when not given supplemental iron 80 % of normal pregnant women will have Hb value less than 11g/dl at term.

- Correct the underlying causes.



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