Frequency of Megaloblastic Anemia with Thrombocytopenia in Pregnant Patients at Tertiary Care Hospital Karachi

Takasur Bibi; Shagufta Khan; Memoona Rehman; Sania Ali; Amber Ahmed

doi:10.70749/ijbr.v3i2.672

Authors

Takasur Bibi Department of Gynaecology and Obstetrics, Jinnah Post Graduate Medical Centre, Karachi, Sindh, Pakistan.
Shagufta Khan Department of Gynaecology and Obstetrics, Jinnah Post Graduate Medical Centre, Karachi, Sindh, Pakistan.
Memoona Rehman Department of Gynaecology and Obstetrics, Jinnah Post Graduate Medical Centre, Karachi, Sindh, Pakistan.
Sania Ali Department of Gynaecology and Obstetrics, Jinnah Post Graduate Medical Centre, Karachi, Sindh, Pakistan.
Amber Ahmed Department of Gynaecology and Obstetrics, Agha Khan University Hospital, Karachi, Sindh, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i2.672

Keywords:

Megaloblastic Anesmia, Thrombocytopenia, Pregnant Women, Placental Abruption, Stillbirth

Abstract

Objective: To determine the frequency of megaloblastic anemia with thrombocytopenia in pregnant patients at Tertiary Care Hospital, Karachi. Study Design and Setting: This cross sectional study was conducted at the Department of Gynecology and Obstetrics, JPMC, Karachi from June 2024 to December 2024. Methodology: This cross-sectional study was conducted after approval of a synopsis from the Research Department of the College of Physicians and Surgeons Pakistan and the institutional ethical review committee. Eligible patients at the Department of Gynaecology and Obstetrics, JPMC, Karachi, who meet the inclusion and exclusion criteria were enrolled in the study. Study was completed from June 2024 to December 2024 .All the findings of variables such as age, occupational status, parity, gravida, gestational age, educational status, chicken and beef consumption, vegetable consumption, serum hemoglobin, serum folic acid, vitamin B12, platelets, and megaloblastic anemia were noted. Results: In this study, patients with megaloblastic anemia with thrombocytopenia had a mean age of 27.51±6.18, gestational age of 33.46 ± 4.41, 22% were primipara and 78% were multipara, vitamin B12 deficiency was found in 36.6%, 46.3% were primi-gravid, 53.7% were multi gravida, MCV was 94.58±4.79, serum Hb 12.39 ± 1.07, platelet 117.22 ± 8.55, folic acid deficiency was observed in 80%, occupationally 46.3% were employed and 53.7% unemployed, and 36.6% were illiterate. It's reassuring to note that the consumption of green leafy vegetables was equally distributed among patients with megaloblastic anemia and those without. Conclusions: This study reveals 18.5% of pregnant women had megaloblastic anemia with thrombocytopenia. This study illustrates that severe megaloblastic anemia and thrombocytopenia caused by dietary deficiencies, such as folic acid and vitamin B12, have a favorable prognosis when correctly diagnosed and treated.

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References

Singh, J., Kumari, K., & Verma, V. (2020). Study of thrombocytopenia in pregnancy: Clinical presentation and outcome at tertiary care rural institute. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 9(4), 1622. https://doi.org/10.18203/2320-1770.ijrcog20201234

Chandra, J. (2010). Megaloblastic anemia: Back in focus. The Indian Journal of Pediatrics, 77(7), 795-799. https://doi.org/10.1007/s12098-010-0121-2

Ruszala, M., Poniedziałek-Czajkowska, E., Mierzynski, R., Wankowicz, A., Zamojska, A., Grzechnik, M., Golubka, I., Leszczynska-Gorzelak, B., & Gogacz, M. (2021). Thrombocytopenia in pregnant women. Ginekologia Polska, 92(8), 587-590. https://doi.org/10.5603/gp.a2021.0147

Samuels, P. (2007). Hematologic complications of pregnancy. Obstetrics: Normal and Problem Pregnancies, 1044-1063. https://doi.org/10.1016/b978-0-443-06930-7.50042-6

Moghadam, S., & Ghorbani, M. (2016). A case of megaloblastic anemia with Thrombocytopenia. Open Journal of Obstetrics and Gynecology, 06(09), 534-538. https://doi.org/10.4236/ojog.2016.69068

Subtil, S. F., Mendes, J. M., Areia, A. L., & Moura, J. P. (2020). Update on Thrombocytopenia in pregnancy. Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 42(12), 834-840. https://doi.org/10.1055/s-0040-1721350

Moulinet, T., Dufrost, V., Clerc-Urmès, I., Wahl, D., & Zuily, S. (2021). Risk of thrombosis, pregnancy morbidity or death in antiphospholipid antibodies positive patients with or without thrombocytopenia. European Journal of Internal Medicine, 84, 101-103. https://doi.org/10.1016/j.ejim.2020.10.011

Sojitra, M., Shah, S. R., Mehta, A. V., Panchal, P. P., & Bhankhar, R. (2020). Maternal outcome in pregnancy with thrombocytopenia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 9(7), 2895. https://doi.org/10.18203/2320-1770.ijrcog20202729

Halici-Ozturk, F., Ozturk, M., Yakistiran, B., Caglar, A. T., Engin-Ustun, Y., & Ozgu-Erdinc, A. S. (2020). Severe thrombocytopenia in pregnancy: A retrospective study. Blood Coagulation & Fibrinolysis, 31(8), 517-521. https://doi.org/10.1097/mbc.0000000000000955

Ijaz, T., Atif, M., Ullah, M., Arshad, S., Ashraf, S., Munir, S., ... & Waqar, A. B. (2016). Prevalence of anemia and thrombocytopenia in pregnant females of Lahore. Life Sci Int J, 10(01), 38-42.

Vishwekar, P. S., Yadav, R. K., & Gohel, C. B. (2017). Thrombocytopenia during Pregnancy and Its Outcome-A Prospective Study. Journal of Krishna Institute of Medical Sciences (JKIMSU), 6(1).

Nisha, S., Amita, D., Uma, S., Tripathi, A. K., & Pushplata, S. (2011). Prevalence and characterization of Thrombocytopenia in pregnancy in Indian women. Indian Journal of Hematology and Blood Transfusion, 28(2), 77-81. https://doi.org/10.1007/s12288-011-0107-x

Tran, P. N., & Tran, M. (2018). Cobalamin deficiency presenting with thrombotic microangiopathy (TMA) features: A systematic review. Transfusion and Apheresis Science, 57(1), 102-106. https://doi.org/10.1016/j.transci.2018.01.003

Vyas, R., Shah, S., Yadav, P., & Patel, U. (2014). Comparative study of mild versus moderate to severe thrombocytopenia in third trimester of pregnancy in a tertiary care hospital. NHL Journal of Medical Sciences, 3(1).

Elgari, M. (2013). Evaluation of hematological parameters of sudanese pregnant women attending at Omdurman al Saudi maternity hospital. Egyptian Academic Journal of Biological Sciences. C, Physiology and Molecular Biology, 5(1), 37-42. https://doi.org/10.21608/eajbsc.2013.16108

Townsley, D. M. (2013). Hematologic complications of pregnancy. Seminars in Hematology, 50(3), 222-231. https://doi.org/10.1053/j.seminhematol.2013.06.004

Ujjan, I., Shaikh, I. A., Khokhar, N. A., Memon, R. A., & Farooq, M. (2010). Frequency of causes of pancytopenia in patients admitted at Isra University Hospital Hyderabad. Pak J Med Health Sci, 4(4), 416-8.

BOEHLEN, F., HOHLFELD, P., EXTERMANN, P., PERNEGER, T. V., & DE MOERLOOSE, P. (2000). Platelet count at term pregnancy. Obstetrics & Gynecology, 95(1), 29-33. https://doi.org/10.1097/00006250-200001000-00006

Khan A, Aqeel M, Khan TA, Munir A. Patterns of haematological diseases hospitalized pediatric patients based on bone marrow examination. J Post Graduate Med Institute 2008; 22(3): 196-200.

Stabler, S. P. (2013). Clinical Practice: Vitamin B12 Deficiency. New England Journal of Medicine, 368(2), 149-160. https://doi.org/10.1056/nejmcp1113996