How to treat megaloblastic anemia during pregnancy

Anemia in pregnant women is a relatively serious disease that can have a huge impact on the development of the fetus. Therefore, every pregnant woman must undergo a blood test in the early stages of pregnancy. There are many types of anemia in pregnant women, among which pregnancy complicated with megaloblastic anemia is the most serious. So, how to treat pregnancy complicated with megaloblastic anemia?

The disease is mainly caused by malnutrition and folic acid deficiency, and a very small part is caused by vitamin B12 deficiency. Folic acid and vitamin B12 are both important coenzymes in the synthesis of DNA. Folic acid itself is inactive, and it is tetrahydrofolate that acts as a coenzyme. Tetrahydrofolate is produced from dihydrofolate by the action of folate reductase. It is very unstable and easily oxidized. Therefore, this disease can occur in any situation that blocks the production of tetrahydrofolate and causes folic acid metabolism disorders.

The diagnosis of this disease can be aided by the clinical symptoms of folic acid and vitamin B12 deficiency, as well as changes in bone marrow and blood counts.

1. Strengthen nutritional guidance during pregnancy, change bad eating habits, eat more fresh vegetables, fruits, melons, beans, meat, animal liver and kidneys and other foods.

2. In the second half of pregnancy, give 5 mg of folic acid orally daily, or 10-30 mg of folic acid intramuscularly once a day until the symptoms disappear and anemia is corrected. If the treatment effect is not significant, you should check for iron deficiency and give iron supplements at the same time.

3. Vitamin B12 100 μg intramuscular injection, once a day for 2 weeks. Later change to twice a week until hemoglobin returns to normal. For patients with neurological symptoms, taking folic acid alone may aggravate the symptoms and should be used with caution.

4. When hemoglobin is <60g/L, small amounts of fresh blood or concentrated red blood cells can be transfused intermittently.

5. Avoid prolonged labor, prevent postpartum hemorrhage, and prevent infection during delivery.