Page 205 - Critical Maternity & Newborn Health Nursing

Normal folate requirement is 500 ug /day and a similar amount is needed

during pregnancy so that the daily requirement during pregnancy is 1

mg.

Etiology.

1. Inadequate intake.

2. Defective absorption.

3. Increased demand e.g. pregnancy.

4. Drugs: folic acid antagonists as epanutin (anti-epileptic).

Clinical Picture:

• General symptoms of anemia .

• GIT manifestations in the form of:

- Dyspepsia, -Anorexia. - Nausea, - Vomiting, -Diarrhea.

-Beefy (red, glased) tongue, - Hepatosplenomegaly.

Investigations:

1. Blood film:

- Macrocytic hyperchromic RBCs.

- Hyper segmented neutrophilic nuclei (>5 lobes).

2. Serum folate level: is low measured by radioimmunoassay.

3. Bone marrow: abnormal red cell precursors (megaloblasts).

Treatment:

- Diet rich in folic acid as liver, kidney and meat.

- Folic acid 5-15 mg /day orally

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