Role of Mentzer index for differentiating iron deficiency anemia and beta thalassemia trait in pregnant women.

Shagufta Tabassum,Mehnaz Khakwani,Asiya Fayyaz,Nadia Taj

doi:10.12669/pjms.38.4.4635

Shagufta Tabassum, Mehnaz Khakwani + Show 2 more

Open Access

https://doi.org/10.12669/pjms.38.4.4635

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Abstract

Objective:To observe the role of Mentzer index for differentiating iron deficiency anemia (IDA) and beta thalassemia trait (β TT) in pregnant women.Methods:This cross-sectional study was conducted in Gynaecology & Obstetrics Department of Nishtar Medical University from October 2020 to March 2021. Non-consecutive sampling was applied. A total of 100 antenatal ladies with hemoglobin <11 gm/dl were included. Their complete blood counts were checked and Mentzer Index was calculated. Mentzer Index <13 points to diagnosis of β TT and >13 indicates IDA. The diagnoses were confirmed by serum iron studies and Hb electrophoresis. The sensitivity and specificity of Mentzer Index for both causes of microcytic hypochromic anemia was calculated.Results:Out of total 100 patients with microcytic hypochromic anemia, 87 had Mentzer Index >13 and IDA was confirmed in 86 out of 87 cases. Thirteen cases had Mentzer Index <13 and β TT was confirmed in eight of them. Thus, Mentzer Index has a sensitivity and specificity of 91% & 83% for IDA and 83% & 91% for β TT.Conclusion:In this study, it was found that Mentzer Index can be used as a discriminatory test to differentiate between iron deficiency anemia and beta thalassemia trait. The high risk group can then be subjected to definitive diagnostic tests. This can result in better patient compliance and cost effectiveness.

Highlights

Anemia in pregnancy is a global health concern[1] encountered by obstetricians worldwide
While iron supplements are very beneficial in iron deficiency anemia (IDA), they can be devastating if the anemia is due to thalassemia
Mentzer Index is calculated as mean corpuscular volume (MCV)(fl) / red blood cell (RBC) count; if the result is >13, IDA is the probable diagnosis while a value < 13 indicates to likelihood of beta cell thalassemia.[11]

Summary

INTRODUCTION

Anemia in pregnancy is a global health concern[1] encountered by obstetricians worldwide. In Pakistan, anemia in pregnancy has high prevalence of about 42%,4 so much so that prophylactic iron supplements are prescribed to almost all pregnant ladies This anemia is most likely due to iron deficiency but may be due to underlying hemoglobinopathy, most common of whom is beta thalassemia trait (β TT). Mentzer Index is calculated as MCV(fl) / RBC count (millions per microliter); if the result is >13, IDA is the probable diagnosis while a value < 13 indicates to likelihood of beta cell thalassemia.[11]. Those with Mentzer Index

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