Low MCV in Pregnancy: Is It Iron Deficiency Anemia? - Obstetrics and Gynecology

Share to:

Abnormal MCV (Mean Corpuscular Volume)


Hello doctor, my fiancée is currently 14 weeks pregnant.
Today, we reviewed her last blood test report, which showed an MCV value of just over 79.
However, during a company health check last March, her MCV value was 83.9.
Should we be concerned about Mediterranean anemia, or is it likely just simple iron deficiency anemia?

Mr. Wu, 20~29 year old female. Ask Date: 2020/11/24

Dr. Zhang Kunmin reply Obstetrics and Gynecology


Hello, based on your description, it is advisable to check your MCV first.
If it is normal, then there is no concern.
Thank you! Wishing you peace and health, Dr.
Chang.

Reply Date: 2020/11/24

More Info


Understanding low Mean Corpuscular Volume (MCV) during pregnancy is crucial, especially when differentiating between iron deficiency anemia and conditions like thalassemia (Mediterranean anemia). In your case, your fiancée's MCV value of around 79 fL during her 14th week of pregnancy is indeed lower than the normal range, which typically falls between 80 and 100 fL. This low MCV can indicate microcytic anemia, which is often associated with iron deficiency or thalassemia.

Firstly, it’s important to understand that MCV measures the average size of red blood cells (RBCs). A low MCV indicates that the RBCs are smaller than average, which can occur in several types of anemia. In pregnant women, the most common cause of low MCV is iron deficiency anemia, particularly because the body requires more iron during pregnancy to support the growing fetus and increased blood volume.
In your fiancée's case, the previous MCV of 83.9 fL suggests that she may have had normal-sized red blood cells before pregnancy. The drop in MCV to 79 fL could indicate that she is experiencing iron deficiency anemia due to the increased demands of pregnancy. However, it is also essential to consider that thalassemia can present with low MCV as well, and it can sometimes be asymptomatic, especially in carriers of the trait.

To differentiate between iron deficiency anemia and thalassemia, additional tests are necessary. These may include:
1. Iron Studies: This includes serum iron, ferritin, total iron-binding capacity (TIBC), and transferrin saturation. In iron deficiency anemia, ferritin levels are typically low, while in thalassemia, iron studies may show normal or elevated iron levels.

2. Hemoglobin Electrophoresis: This test can help identify different types of hemoglobin and is particularly useful in diagnosing thalassemia. If your fiancée is a carrier of thalassemia, this test will reveal the specific type of thalassemia trait she may have.

3. Complete Blood Count (CBC): While you have already noted the MCV, other parameters like hemoglobin concentration, red cell distribution width (RDW), and the presence of microcytic or hypochromic red blood cells can provide additional clues.

4. Family History: Since thalassemia is a genetic disorder, understanding the family history of both partners can provide insights into the likelihood of being carriers.

Given that your fiancée had a normal MCV previously, it is plausible that her current low MCV is related to iron deficiency due to pregnancy. However, it is essential to rule out thalassemia, especially if there is a family history or if she has Mediterranean ancestry, as this condition is more prevalent in those populations.

In conclusion, while low MCV during pregnancy is often attributed to iron deficiency anemia, it is crucial to conduct further testing to confirm the diagnosis. If iron deficiency is confirmed, dietary changes, iron supplementation, and monitoring will be necessary to ensure both maternal and fetal health. If thalassemia is suspected, genetic counseling may be beneficial for both partners to understand the implications for future pregnancies. It is advisable to consult with a healthcare provider who specializes in maternal-fetal medicine or hematology for further evaluation and management.

Similar Q&A

Understanding Low MCV: Is It Iron Deficiency or Thalassemia?

Recently, I have been frequently visiting the emergency room and cardiology outpatient clinic due to heart issues, but no problems have been identified. Later, it was confirmed at the psychosomatic clinic that I have panic disorder. Below are the blood test results from three wee...


Dr. Huang Yinghe reply Cardiology
Hello: Low hemoglobin levels are referred to as anemia. MCV (Mean Corpuscular Volume) is the average volume of red blood cells. Anemia combined with low MCV indicates microcytic anemia, which is commonly associated with two conditions: iron deficiency anemia or thalassemia. Thala...

[Read More] Understanding Low MCV: Is It Iron Deficiency or Thalassemia?


Understanding Anemia: Differentiating Between Iron Deficiency and Thalassemia

Hello Doctor: I recently underwent two health check-ups, one on June 21 for a company physical exam and another on July 2 for my first prenatal check-up (I am currently three months pregnant). In terms of blood tests, many of my values did not meet the standard thresholds. I woul...


Dr. Liao Yaopan reply Family Medicine
Hello, based on your test results, there is a slight indication of anemia in your hemoglobin levels. We recommend further evaluation, and it would be advisable to follow up with a hematologist since you are currently pregnant. You may also consult with an obstetrician to assess f...

[Read More] Understanding Anemia: Differentiating Between Iron Deficiency and Thalassemia


Understanding Anemia in Pregnancy: Why Iron Supplements May Fail

When I first became pregnant, my hemoglobin level was 11.6. Around 30 weeks, a blood test showed that my hemoglobin had dropped to 8.8. The doctor prescribed iron supplements (Iron Chewable Tablets) at a dosage of 100 mg daily. At 33 weeks, my hemoglobin remained at 8.8, but by 3...


Dr. Huang Jianzhong reply Obstetrics and Gynecology
At the beginning of the pregnancy, the hemoglobin level was 11.6, but around 30 weeks, a blood test showed that the hemoglobin had dropped to 8.8. The doctor prescribed iron supplements (Iron Chewable Tablets) at a dosage of 100 mg daily. At 33 weeks, the hemoglobin remained at 8...

[Read More] Understanding Anemia in Pregnancy: Why Iron Supplements May Fail


Understanding Anemia and Heart Health During Pregnancy: What You Need to Know

I am currently a mother scheduled for a cesarean section, but since my first prenatal check-up, my blood test report indicated anemia. The prenatal nurse has consistently suspected that I have thalassemia. This time, my blood test results have all decreased, and the nurse said I ...


Dr. He Dongjin reply Cardiology
Hello, I also suspect it may be Mediterranean anemia. It is advisable to consult a hematologist for further examination. Changhua Hospital cares about you.

[Read More] Understanding Anemia and Heart Health During Pregnancy: What You Need to Know


Related FAQ

Thalassemia

(Obstetrics and Gynecology)

Umbilical Cord Blood

(Obstetrics and Gynecology)

Preeclampsia

(Obstetrics and Gynecology)

Menstrual Abnormalities

(Obstetrics and Gynecology)

Pregnant Women

(Nutrition)

Pregnancy Bleeding

(Obstetrics and Gynecology)

Vitamins

(Obstetrics and Gynecology)

Menarche

(Obstetrics and Gynecology)

Menstrual Cramps

(Obstetrics and Gynecology)

Delayed Menstruation

(Obstetrics and Gynecology)