Which peripheral blood finding is most characteristic of megaloblastic anaemia in pregnancy?

• A Spherocytes
• B Target cells
• C Hypersegmented neutrophils ✓
• D Bite cells

Explanation

Impaired DNA synthesis from folate or vitamin B12 deficiency causes nuclear-cytoplasmic asynchrony, producing macro-ovalocytes and neutrophils with five or more nuclear lobes. Hypersegmented neutrophils appear early, often before overt macrocytosis, making them the most characteristic finding. Target cells suggest liver disease or haemoglobinopathies, spherocytes indicate hereditary spherocytosis or immune haemolysis, and bite cells point to oxidative haemolysis such as G6PD deficiency.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.