Anemia during pregnancy is defined as a serum hemoglobin of less than 10.5 g/dL in the second trimester of pregnancy, and it is defined as a serum hemoglobin of less than 11 g/dL in the third trimester of pregnancy. There is evidence that maternal anemia raises the likelihood of health issues occurring in both the mother and the child. The anemia known as megaloblastic anemia is characterized by macrocytosis as a consequence of the reduction of DNA synthesis while erythropoiesis is taking place. This results in an increased number of red blood cells. The presence of megaloblastic anemia is often identified by chance during the course of routine blood testing. The only persons who have symptoms of anemia during pregnancy are those who already have a severe level of anemia. If treatment for megaloblastic anemia is not received, the condition may lead to thrombocytopenia. The first step in diagnosing megaloblastic anemia is identifying the morphological (increased mean cellular volume) and laboratory (specific vitamin deficiency) symptoms of megaloblastosis. This will lead to the identification of megaloblastic anemia. We take a look at the situation of a woman in her thirties who is expecting a child but has been told she has significant megaloblastic anemia and thrombocytopenia.