ceelbardaleh

Health 

 VITAMIN  B12 DEFICIENCY

like folic accid, vitamins  b12 is essential for cell division, hence requirement for it increases during pregnancy. animal products are  the main source. Unlike. Folic acid,stores in the liver are enough to supply up to two years, needs. Daily requirements are so low (3 ug in pregnant women) that gross dietary deficiency is rare except in southern  India where it is seenasa results of low intake by vegetarians  with intestinal malabsorption

Malarial  anaemia follows repeated faciparum parasitaemia and its features in partially immune and non-immune women are not exactly identical. In the partially immune, the anaemia starts in the second trimester of pregnancy and younger women and primigravidae are more vulnerable then older women and multigravaidae various immune haemolytic processes triggered by Malarial 

Parasitaemia act as the principal cause ,with erythrophagocytosis,folic  acid deficiency and hypersplenism being aggravating factors. Often  the severity of anaemia and the degree of parasitaema  do not match. Stained  blood films rarely show parasitaemia ,

the parasitised red calls having been destroyed or removing  from the circulation. The causal immune  mechanism sometimes continue for months after parasitaemia chapter 7 provides  further information in  non- immune women, 

Anaemia can complicate a severe Malarial attack at any stage of pregnancy and there are no party  differences. The pathogenesis is  also multifactorial acute haemolysis (not necessarily immune- mediated) impaired marrow function and secondary bacterial infection are all involved. The degree of anaemia correlates well with parasitaemia  thrombocytopenia is  common a useful diagnostic feature is the presence of Malaria pigment in  monocytes in Stained  blood films.