Severe Anaemia during Late Pregnancy

Mahenaz Akhtar,Ismail Hassan

doi:10.1155/2012/485452

Abstract

Vitamin B12 deficiency is uncommon in pregnancy, it occurs in 10–28% of uncomplicated pregnancies, and is associated with a few complications. We present a case report of a 21-year-old patient with severe anaemia during late pregnancy caused by vitamin B12 deficiency. At 38 weeks gestation and with a BMI of 48.9, a history of rupture of membranes was given but not confirmed. On examination, she appeared pale and therefore full blood counts were done. Interestingly her haemoglobin (Hb) levels were 3.7 g/dL. Folate and vitamin B12 levels were also found to be low, and the diagnosis of anaemia caused by vitamin B12 deficiency was made. After treatment with vitamin B12 injections, folic acid and blood transfusions, the patient's haemoglobin levels improved from 3.7 g/dL to 10.7 g/dL. The conclusion is that effective history taking, diagnosis, and management can prevent many complications that are usually associated with vitamin B12 deficiency anaemia.

Highlights

Anaemia during pregnancy is common and has both maternal and foetal consequences [1]
A diagnosis of anaemia can be made if haemoglobin levels are less than 11.0 g/dL in the last trimester of pregnancy [1]
Foetal vitamin B12 stores should be 25–50 μg [5]. 20% of women show a physiological drop in vitamin B12 levels during pregnancy, with lowest levels reached at third trimester [3, 4, 6]

Summary

Introduction

Anaemia during pregnancy is common and has both maternal and foetal consequences [1]. The most common cause is iron deficiency anaemia, other causes include infection, folate, and vitamin B12 deficiency [1, 2]. Anaemia caused by vitamin B12 deficiency occurs in 10– 28% of uncomplicated pregnancies [3]. Foetal vitamin B12 stores should be 25–50 μg [5]. 20% of women show a physiological drop in vitamin B12 levels during pregnancy, with lowest levels reached at third trimester [3, 4, 6]. We report the case of a 21-year-old with severe anaemia caused by vitamin B12 deficiency at 38 weeks gestation

Case Report

Discussion

Conclusion