dx n mx of folic acid anaemia

1. Presented by-
Subhrajit Das
Roll no- 72
8th semester

2. Folic acid deficiency anaemia in India making
up 3-4 % of all pregnancy anaemia.
Aetiology:-
• Diet-- poor intake of vegetables
• Malabsorption–e.g: Coeliac disease,
• Increased demand– Cell proliferation,e.g: haemolysis
Pregnancy.
• Drugs-- Certain anticonvulsants(phenytoin).
Certain cytotoxic drugs (methotrexate).

3. SYMTOMS:-
• Asymtomatic
• Loss of appetite
• Vomitting
• Diarrhoea
• Unwell with unexplained fever.

4. SIGNS:-
• Pallor Bleeding points on skins,
• Enlarged spleen and liver,
• Neuropathy

5. COMPLICATION:-
MATERNAL:-
• PIH
• Abruptio placenta .
FETAL:-
Folate deficiency in mother can cause
• Neural tube defects
• Abortion
• IUGR
• Premature/small for date.
• Poor folate level in newborn.

6. CHARACTERISTICS NORMAL RANGE FOLIC ACID
DEFICIENCY
Haemoglobin 10—14 gm% <10gm%
MCV 75—94 fl > 94 fl
MCH 27– 33 pg > 33 pg
MCHC 30-35 gm/dl Normal

7. CHARACTERISTICS NORMAL RANGE FOLIC ACID
DEFICIENCY
PBF Normocytic,
Normochromic
Megaloblastic,
neutropenia,
thrombocytopeni
a,
hypersegmentati
on of neutrophil
Serum folate > 3 µg/L < 3 µg/L
Red cell folate > 150 ng/dl < 150 ng/dl
Serum iron 60—120 µg/dl Normal
Serum lactate
dehydrogenase
increased
Serum
homocysteine
Increased

8. PR0PHYLACTIC THERAPY:-
• All women of reproductive age should be given
400 µg folic acid daily.
• Multiple pregnancy, pt having anticonvulsant therapy,
haemoglobinopathies or associated chronic infection
or diseases ---In this condition additional amount(4
mg) should be given.
• Women, who have infants with neural tube defects,
should be given 4 mg folic acid daily beginning 1
month before conception to about 12 weeks of
pregnancy.

9. CURATIVE THERTAPY:-
• Daily admininistration of folic acid 4 mg orally which
should be continued for 4 weeks following delivery.
• Supplementation of 1 mg folic acid daily along with
iron & nutritious diet can improve pregnancy induced
megaloblastic anemia by 7-10 days.
• Folic acid should never be given without supplemental
iron.
• Supplementary i.m. vit-B12 100 µg daily or on
alternative days may be added when response to folic
acid alone is not adequate.
• Ascorbic acid 100 mg tab thrice daily enhances the
action of fplic acid by converting it into folimic acid.

10. THANK YOU