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SYNOPSIS It has been shown that the incidence of megaloblastic anaemia in a group of 463 randomly selected pregnant women receiving iron was 12 times as high as in a control group of 235 pregnant women receiving iron and folic acid. The incidence of all types of anaemia in the women receiving iron alone was more than three times the incidence in those having iron and folic acid. Some women who were not anaemic or who had normoblastic anaemia had serum folate levels in the same range as the women with megaloblastic anaemia, but none of the women with megaloblastic anaemia had high serum folate levels. The labile fraction of the serum folate was no more reliable than the total serum folate as a diagnostic criterion of megaloblastic crythropoiesis in the individual case. The blood group distribution in the women with megaloblastic anaemia was the same as in the general population. Babies born to mothers with megaloblastic anaemia tended to be smaller than the rest, although there was no difference in the placental weights.The significance of these findings is discussed.Megaloblastic erythropoiesis, with a varying degree of anaemia, is now known to be common in pregnancy. Although erythropoiesis is restored to normal by folic acid, estimation of the total serum folate is not a reliable guide to diagnosis, as it is in other folate-deficiency states such as steatorrhoea. It has been claimed that the level of the labile fraction of the serum folate (probably 5-methyl-tetrahydrofolic acid) is a reliable diagnostic criterion (Ball and Giles, 1964;Giles, 1966). If this is so, then an important factor in the pathogenesis of megaloblastic anaemia of pregnancy would seem to be an inability to metabolize folate compounds to their most useful form.There have been conflicting reports about the incidence of serious complications such as toxaemia, abortion, antepartum haemorrhage, and premature labour in pregnant women with megaloblastic anaemia (Gatenby and Lillie, iPresent address: Mill Road Maternity Hospital, Liverpool

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SummaryThe effect of phenformin and ethyloestrenol on the incidence of post-operative deep venous thrombosis was studied in 314 surgical patients in a double-blind randomised trial.Although the laboratory tests suggested that the regime produced an increase in activators of the fibrinolytic system, the drugs used did not lower the incidence of post-operative deep venous thrombosis.Possible explanations of this paradox are advanced.

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