Haematinic deficiency in pregnancy: another HELLP mimic

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Nutritional Science

Background:

• Haematinic deficiency, particularly folate deficiency, is common during pregnancy.
• Pregnancy increases folate demand, and B12 stores deplete slowly, making folate deficiency more prevalent.

Purpose of the Study:

• To describe five cases of pregnancy anemia caused by severe haematinic deficiency.
• To outline the management and pregnancy outcomes for these cases.

Main Methods:

• Case series of five pregnant women with severe anemia.
• Diagnosis based on low folate (<3 μg/L) and B12 levels.
• Treatment included high-dose folic acid, parenteral vitamin B12, and oral iron.

Main Results:

• All patients presented with severe anemia secondary to folate and B12 deficiency.
• Women were often proteinuric but otherwise well and normotensive.
• High-dose vitamin and iron supplementation led to good hematological recovery.

Conclusions:

• Severe haematinic deficiency in pregnancy can mimic other conditions like TTP or HELLP syndrome.
• Antenatal correction of vitamin deficiencies prevents bone marrow suppression.
• Effective management minimizes adverse obstetric outcomes, including postpartum hemorrhage.