PMID: 5904977Jan 1, 1966

An account of 335 cases of megaloblastic anaemia of pregnancy and the puerperium

Journal of Clinical Pathology
C GILES

Abstract

The incidence of megaloblastic anaemia in pregnancy and the puerperium in north Staffordshire has steadily declined as a result of prophylaxis with folic acid. In the presence of advanced folic acid deficiency and with a florid megaloblastic marrow, the anaemia is usually severe, but in many patients the disease is relatively mild and the degree of anaemia is determined more by blood loss or associated iron deficiency than by the megaloblastosis. Microscopic examination of marrow films is still the most reliable method of diagnosis, although estimation of the labile serum folate has produced a 95% correlation with the marrow findings. There are three main factors which operate in the pathogenesis of megaloblastic anaemia in pregnancy and the puerperium. First, the maternal stores of folic acid are used up by the growing foetus, and this process is accelerated in multiple pregnancies, after haemorrhage, or in women with haemolytic anaemia. Secondly, an insufficient intake of folic acid, due to poor diet in pregnancy, plays a part in many cases. The third, and possibly the most important, factor is an absorption defect. Folic acid absorption is usually impaired in established cases, and this can still be demonstrated years later ...Continue Reading

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Related Concepts

Microangiopathic Hemolytic Anemia
Anemia, Macrocytic
Blood
Blood Group Antigens
Folic Acid, Sodium Salt
Hemorrhage
Iron
Pregnancy Complications, Hematologic
Puerperal Disorders
Eritron

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