title: Clinical evaluation of severe anemia in pregnancy with special reference to macrocytic anemia.
abstract: OBJECTIVE
  Anemia in pregnancy has been almost synonymous with iron-deficiency anemia but there appears to be a changing trend with emerging evidence of macrocytic anemia. The aim of this study was to evaluate the clinical profile of patients having severe anemia in pregnancy.
  
  
  METHODS
  This study included all antenatal patients presenting with severe anemia (hemoglobin<7gm%) over a period of 2years from January 2008 to December 2009 in the Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi.
  
  
  RESULTS
  Although iron-deficiency anemia remains the most important cause of anemia (48.1%) there is also a high prevalence of macrocytic anemia (40%) amongst these cases of severe anemia in pregnancy. The maternal and fetal morbidity and mortality is higher in macrocytic anemia as compared to iron-deficiency anemia.
  
  
  CONCLUSIONS
  There is an emerging trend of macrocytic anemia among antenatal patients with severe anemia. Both maternal and fetal morbidity appears to be higher in these cases. This has important implications in terms of diagnosis and therapy to optimize both maternal and perinatal outcomes. Once clinicians and health administrators recognize the magnitude of this problem it may be considered relevant to start public health interventions by way of requirement of appropriate food fortification.
authors: Departments of Obstetrics and Gynaecology Pathology, Maulana Azad Medical College, New Delhi, India. revatripathi@gmail.com
authors: Reva
authors: R
authors: Tripathi
authors: Shakun
authors: S
authors: Tyagi
authors: Tejinder
authors: T
authors: Singh
authors: Amrapali
authors: A
authors: Dixit
authors: Manju
authors: Y M
authors: YM
authors: Mala
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis; D000748:Anemia, Macrocytic / Q000175:diagnosis*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis*; D011256:Pregnancy Outcome; D012189:Retrospective Studies