Pregnancy with pancytopenia: an observational study

Abstract

<jats:p>Background: Pancytopenia is the reduction in all three major cellular elements of blood; hence it is the simultaneous presence of anaemia, leukopenia and thrombocytopenia. Pancytopenia is associated with many maternal and foetal complications during pregnancy like maternal sepsis, postpartum haemorrhage, pre-eclampsia and preterm labour, IUGR and intrauterine foetal demise.Methods: The study was conducted at BLDE (Deemed to be) University, Shri B. M. Patil Medical College Hospital and Research Centre. It’s an observational study done from November 2019-April 2020. The participants enrolled in the study were subjected for further clinical and laboratory evaluation and followed for feto-maternal outcome.Results: The incidence of pancytopenia with pregnancy in this study was 3% and all the patients were vegetarian by diet along with vitamin B12 and folic acid deficiency. They were associated with different maternal and foetal complications.Conclusions: Proper dietary counselling and well-balanced dietary plans even with plant originate food can prevent the micronutrients deficiency and avoid the deleterious consequences like pancytopenia.</jats:p>

A Clinical Study on Pancytopenia in Pregnancy in Women of Rural Haryana

“…Pancytopenia, classically defined as reduction of all the three major cellular components of blood, results in anemia, leukopenia and thrombocytopenia [1,2]. This entity can involve the bone marrow primarily or secondarily depending on various underlying pathologies.…”

“…Vitamin B12 deficiency has been established as an important cause of pancytopenia as it has a specific role in DNA synthesis & carbon metabolism. Deficiency of Vitamin B12 is common in pregnancy owing to increased fetal demand as the pregnancy advances and its deficiency leads to defective erythropoiesis and neuronal defective myelination [1,3,4].…”

“…It might go undetected in its early stages because of mild impairment in the bone marrow and might become apparent during periods of stress or increased demand e.g. Pregnancy, infection, bleeding, bone marrow failure syndromes and malignancies [1,[5][6][7]. Many non-malignant conditions e.g.…”

“…infections (HIV, EBV, TB) and nutritional deficiency anemias (severe vit B12 and folic acid deficiency), might also present as pancytopenia. Tormand Rognen et al in their study proves a strong association between maternal Vit B12 deficiency and preterm birth (PTB) and low birth weight (LBW) [1,3,6]. Pawlak R et al have shown an association of low vit B12 concentration in first trimester of pregnancy and pre-eclampsia in the mothers and neural tube defects (NTD) & neurological impairment in the babies born to those women [1,[4][5][6].…”

“…Pawlak R et al have shown an association of low vit B12 concentration in first trimester of pregnancy and pre-eclampsia in the mothers and neural tube defects (NTD) & neurological impairment in the babies born to those women [1,[4][5][6]. Shravya G et al have reported severe vit-B 12 deficiency in pregnancy mimicking HELLP syndrome [1,7].…”