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VOLUME 2 , ISSUE 2 ( April-June, 2018 ) > List of Articles


Management of a Case of Megaloblastic Anemia with Pancytopenia in Late Pregnancy: A Case Review

Archana M Patil

Keywords : Folic acid, Megaloblastic anemia, Morbidity, Mortality, Pancytopenia, Vitamin B12

Citation Information : Patil AM. Management of a Case of Megaloblastic Anemia with Pancytopenia in Late Pregnancy: A Case Review. World J Anemia 2018; 2 (2):61-65.

DOI: 10.5005/jp-journals-10065-0032

License: CC BY-NC 4.0

Published Online: 01-09-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Aims and objectives: Early diagnosis and management of a case of B12 and folic acid deficiency, as there is no gold standard protocol for diagnosis of this type of anemia. Case report: A 24 years G2P1L1A0 with 32 weeks gestation presented with: Hb: 3 g%, red blood cells (RBCs: 1700 cells/ mm3, white blood cells (WBCs): 2700 cells/mm3, platelets: 80000 cells/mm3. Ultrasound is suggestive of single live intrauterine pregnancy of 32.4 weeks, with cephalic presentation with symmetrical intrauterine growth restriction, amniotic fluid index (AFI): 7–8 cm. Obstetric Doppler suggestive of increased SD ratio in umbilical artery, reduced periodontal index (PI) in the right uterine artery. Patient treated with 3 units of packed cell colume (PCV) with 3 doses of intravenous B12 and vitamin C injections followed by oral iron, oral B12, and folic acid. Patient advised follow-up after 15 days. Reports after 15 days: Hb: 8.6 g%, RBCs: 3.07 x 1012/L, WBCs: 10.2 x 109/L, Pletlets: 33.2 x 109/L Ultrasound is suggestive of single live intrauterine pregnancy of 33.3 weeks gestation with cephalic presentation, AFI: 8–9 cm. Obstetric Doppler: No significant abnormality in obstetric Doppler indices in the present scan. Conclusion: Early intervention and diagnosis of megaloblastic anemia in late pregnancy reduce significant maternal and fetal morbidity and mortality.

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  1. Johnston, Tracey. “Anaemia”, Obstetrics and Gynaecology An evidence – based text for MRCOG (2E), 2010.
  2. www.b12 b12.Home page (Internet)
  3. Garcia SS, Atkins JT, Falchook GS, Tsimberidou AM, Hong DS, Trivedi MV, et al. Transient severe hyperbilirubinemia after hepatic arterial infusion of oxaliplatin in patients with liver metastases. Cancer chemotherapy and pharmacology. 2013 Dec 1;72(6):1265-1271.
  4. Chandra J. Megaloblastic Anaemia. Med IND. (Internet)
  5. Megaloblastic Anaemia. Malaga Health Foundation (Internet).
  6. Davenport DF, Blackford J, Bishop MR, Sommardahl CS, Martin EJ. Equine therapeutic nutrition i & ii, nutritional supplement ingredients, the good, the bad and the useless. Proceedings WWVC. 2002:707-720.
  7. Megaloblastic anaemia. Edit sept 2018 (Internet)
  8. PCOS using hydroxycut Hydroxycut weight Loss Pills – July 27, 2017
  9. Health. Nutritional Imbalance. Vitamin Deficiencies & Excesses.
  10. Megaloblastic Anaemia – Vit B12 deficiency Slide Share
  11. Pernicious Anaemia. Article 164( ) tiss-net mba gk (content/uploads/2019/02/T%C4%B1ss- Net-Mba-Gk- Compendium-2016-17.pdf) http://weiodat.
  12. Akhtar M, Hassan I. Severe anaemia during late pregnancy. Case reports in obstetrics and gynecology. 2012;2012.
  13. Makheja KD, Maheshwari BK, Arain S, Kumar S, Kumari S. The common causes leading to pancytopenia in patients presenting to tertiary care hospital. Pakistan journal of medical sciences. 2013 Sep;29(5):1108-1111.
  14. Vitamin B12 – NIH. B12-Health Professional. Nov 29 2018 (Internet). 15. Ph+ Chronic Myeloid Leukemia(CML) Symptoms - Tasigna https://
  15. Carmen Emanuela, “Chapter 6 New Insights into the Diagnosis and Management of Pregnancy – Related Diabetes Insipidus”, In Tech, 2011.
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