Abstract
Background: Folate and vitamin B 12 deficiency can lead to pancytopenia in pregnancy. Some cases of pancytopenia due to COVID-19 infection have also been reported. The two cases that we present are related to the coincidence of pregnancy and deficiency of folic acid and vitamin B12 with COVID-19 infection.
 Case presentation: A 26-year- woman G3P1L1A1 and 21-year-woman G2P1L1 presented with pancytopenia and mild COVID-19 infection. The antenatal period was uneventful, and both cases also had folate and vitamin B12 deficiency. They received blood products, folic acid, and vitamin B12 supplementation. COVID- 19 infection was managed well with analgesic and vital monitoring. Postpartum hemorrhage occurred in the second case, which was well managed with uterotonics. All laboratory parameters came out to be normal after three months of supplementation of folic acid and vitamin B12.
 Conclusion: Pancytopenia in pregnancy due to folate and vitamin B12 deficiency and COVID- 19 infection can be easily managed with timely intensive targeted therapy, but we should be extra vigilant while handling such complicated cases, keeping in mind all possible differential diagnoses for pancytopenia.
Highlights
Folate and vitamin B 12 deficiency can lead to pancytopenia in pregnancy
Pancytopenia in pregnancy due to folate and vitamin B12 deficiency and COVID- 19 infection can be managed with timely intensive targeted therapy, but we should be extra vigilant while handling such complicated cases, keeping in mind all possible differential diagnoses for pancytopenia
Vitamin B 12 and folate deficiency generally presents as megaloblastic anemia, but its infrequent presentation as pancytopenia has been reported [1]
Summary
Pancytopenia in pregnancy due to folate and vitamin B12 deficiency is a reversible cause. It can be managed with early diagnosis and prompt treatment. Funding The authors received no financial support for their research, authorship, and/or publication of this article. Ethics approval and consent to participate We conducted the research following the Declaration of Helsinki. Author details 1Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India. Article Info Received: 21 June 2021 Accepted: 16 July 2021 Published: 21 July 2021
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