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What is Raised MCV in pregnancy can be due to: and explain in detail?
Ans. is d, i.e. All of the aboveRef. High Risk Pregnancy, Fernando Arias 4/e, p 236, 237The first indication of megaloblastic anemia in pregnancy is usually an elevated red cell MCV. This finding is also seen alcohol or azathioprine use, hypothyroidism and in normal pregnancy.Imp. Points:Diagnostic feature of megaloblastic anemia of pregnancy on blood smear is presence of hyper segmented neutrophils.Megaloblastic anemia can be either due to deficiency of folic acid or vitamin B12 .Diagnostic test for:-Vitamin B12 deficiency--Decreased serum levels of vitamin B12. (<100pg/mL)-Folic acid deficiency--Red cell folate levels. (<160mg/L) and low serum folate levels -<25mg/LMgt:Folic acid deficiency = 1 mg/day Folic acid.Vitamin B12 deficiency = 1000 mg of parenteral cyanocobalamin every week for 6 weeks, followed by 1000 mg intramuscular injections every month.The reticulocyte count shows appropriate response to therapy in 4-6 days and hyper segmentation of neutrophils normally disappears after 2 weeks.