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Reference Values  During Pregnancy


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Mean corpuscular volume (MCV) (whole blood)

   Units Nonpregnant Adult First Trimester Second Trimester Third Trimester

m3

79 -93 85 -97.8 85.8 - 99.4 82.4 - 100.4

fl

79 -93 85 -97.8 85.8 - 99.4 82.4 - 100.4

Some causes of a low MCV include :

Iron deficiency, anemia of chronic disease, Shahidi-Nathan-Diamond syndrome, sideroblastic anemia,  thalassemias, and hemoglobinopathies.

Some causes of a high MCV include
  • Cobalamin (B12) deficiency due to strict vegetarianism, impaired absorption due to numerous conditions ( pernicious anemia, gastrectomy, celiac disease, scleroderma, lymphoma, etc.), parasites, hyperthyroidism, neoplastic disease, pancreatic disease, and enzyme deficiencies.
  • Folate deficiency from alcoholism , lack of vegetables, celiac disease, anticonvulsanats, oral contraceptives, hypothyroidism, infancy, neoplastic disease, exfoliative skin diseases, folic acid antagonists (trimethoprim, methotrexate, etc. ), and hemodialysis .
  • Metabolic inhibitors such as methotreaxte, enzyme deficiencies, Lesch-Nyhan syndrome and other inborn errors.
  • Mild macrocytosis can be seen during normal pregnancy in women who are not iron or folate deficient


References:

1. Lockitch G. Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy. Boca Raton:CRC, 1993.
2. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol. 2009 Dec;114(6):1326-31. PMID:19935037
3. Fischbach FT, Dunning MB III, eds. A Manual of Laboratory and Diagnostic Tests, 7th ed. Philadelphia, Lippincott Williams and Wilkins,2004
4. Chanarin I, et al. The physiological macrocytosis of pregnancy.Br J Obstet Gynaecol. 1977 Jul;84(7):504-8.PMID:911706
 

 

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