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[5]                                                                                                                                                                                                                                              AJDHS.COM 

 

 

Available online at ajdhs.com 

Asian Journal of Dental and Health Sciences 
Open Access to Dental and Medical Research 

Copyright  © 2025 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the 

original author and source are credited  

 

 

The Mentzer Index and Pregnancy: Differentiating Between Iron Deficiency and 
Thalassemia 

Emmanuel Ifeanyi Obeagu *  

Department of Biomedical and Laboratory Science, Africa University, Zimbabwe 

Article Info: 
_____________________________________________ 
Article History: 

Received   02 Nov 2024     
Reviewed  08 Dec 2024 
Accepted   09 Jan 2025 
Published 15 March 2025 

_____________________________________________ 
Cite this article as:  

Obeagu EI, The Mentzer Index and 
Pregnancy: Differentiating Between Iron 
Deficiency and Thalassemia, Asian Journal of 
Dental and Health Sciences. 2025; 5(1):5-10                                                                     

DOI: http://dx.doi.org/10.22270/ajdhs.v5i1.107          

Abstract 
_________________________________________________________________________________________________________________ 

Anemia during pregnancy is a common condition with significant risks for both maternal and fetal 
health. The two primary causes of anemia in pregnancy—iron deficiency anemia (IDA) and 
thalassemia trait (TT)—require distinct treatment strategies. The Mentzer Index, a simple and cost-
effective diagnostic tool, helps differentiate between these two types of anemia by calculating the 
ratio of mean corpuscular volume (MCV) to red blood cell (RBC) count. This review explores the role 
of the Mentzer Index in improving anemia diagnosis and management in pregnancy, highlighting its 
benefits and limitations. The Mentzer Index is calculated by dividing the MCV by the RBC count, with 
values greater than 13 typically indicating IDA and values less than 13 suggesting TT. The index 
offers a quick and accessible method for distinguishing between these two conditions, enabling 
healthcare providers to administer appropriate treatments, such as iron supplementation for IDA or 
genetic counseling for TT. Early and accurate diagnosis through the Mentzer Index can reduce the 
risk of complications such as preterm birth and low birth weight, while ensuring appropriate anemia 
management for pregnant women. 

Keywords: Mentzer Index, Pregnancy, Iron Deficiency, Thalassemia, Anemia Diagnosis 

*Address for Correspondence:   

Emmanuel Ifeanyi Obeagu, Department of Biomedical and Laboratory Science, Africa University, Zimbabwe 

 

Introduction 

Anemia is a widespread condition during pregnancy, 
with studies estimating its global prevalence at around 
40-50%, posing significant risks to both maternal and 
fetal health. Pregnant women are at increased risk for 
anemia due to higher iron requirements for fetal 
development, increased blood volume, and the strain of 
pregnancy itself. The two most common causes of 
anemia during pregnancy are iron deficiency anemia 
(IDA) and thalassemia trait (TT). Though both result in 
low hemoglobin levels, their causes are fundamentally 
different and require distinct approaches to diagnosis 
and management. Accurate differentiation between IDA 
and TT is essential for effective treatment, as iron 
supplementation, the main treatment for IDA, is 
ineffective and potentially harmful in the case of TT.1-2 

The Mentzer Index, a simple calculation based on the 
mean corpuscular volume (MCV) and red blood cell 
(RBC) count, has gained recognition as an effective 
screening tool for distinguishing between these two 
types of anemia. By providing a quick, cost-effective, and 
accessible means to differentiate IDA from TT, the 
Mentzer Index allows healthcare providers to initiate 
appropriate management strategies early in pregnancy. 
A value greater than 13 typically suggests IDA, whereas 
a value less than 13 points towards TT. However, the 
index, while useful, has limitations that must be 

considered in its application.3-4 The importance of 
accurately diagnosing the cause of anemia during 
pregnancy cannot be overstated. Anemia in pregnancy is 
associated with adverse outcomes such as preterm 
birth, low birth weight, and maternal fatigue, which can 
severely affect quality of life. Inadequate or 
inappropriate treatment can exacerbate these risks. 
Therefore, healthcare providers must not only diagnose 
anemia but also identify its underlying cause to ensure 
that appropriate and effective treatments are provided. 
The Mentzer Index offers a valuable tool for this 
purpose, enabling clinicians to quickly rule out iron 
deficiency as the sole cause and investigate further for 
thalassemia traits, which may not require iron 
supplementation.5 

Iron deficiency anemia (IDA) is the most common form 
of anemia during pregnancy, resulting from insufficient 
iron to meet the increased demand of both the mother 
and fetus. IDA can lead to significant complications such 
as maternal fatigue, impaired immune function, and, in 
severe cases, cardiovascular problems. The condition 
can also lead to adverse outcomes for the fetus, 
including intrauterine growth restriction and preterm 
birth. Early identification of IDA allows for timely iron 
supplementation, which is essential in preventing these 
complications. However, in some pregnant women, 
particularly those from regions where thalassemia is 

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Emmanuel Ifeanyi Obeagu                                                                                                        Asian Journal of Dental and Health Sciences. 2025; 5(1):5-10 

[6]                                                                                                                                                                                                                                              AJDHS.COM 

prevalent, thalassemia trait (TT) may be the underlying 
cause of anemia, which does not respond to iron 
supplementation and may require different 
management strategies.6-7 Thalassemia trait is a genetic 
blood disorder that leads to mild anemia but is often 
misdiagnosed as IDA due to overlapping clinical 
features, such as low hemoglobin and low MCV. 
However, unlike IDA, thalassemia trait is not caused by 
iron deficiency and does not require iron 
supplementation. Misidentifying TT as IDA can lead to 
unnecessary iron treatments, which may cause iron 
overload in the body and lead to complications. The 
Mentzer Index helps address this issue by offering a 
simple method for differentiating between the two 
types of anemia based on RBC count and MCV values. 
This distinction is critical because the management of 
TT requires genetic counseling and monitoring, rather 
than iron supplementation.8-9 Despite the value of the 
Mentzer Index in diagnosing anemia, it is important to 
recognize its limitations. While the index is a useful 
screening tool, it cannot definitively diagnose mixed 
anemia, where IDA and TT coexist, or other forms of 
anemia, such as folate or vitamin B12 deficiency. 
Additionally, the index can be influenced by factors such 
as inflammation or concurrent medical conditions that 
affect RBC count and MCV, leading to false or ambiguous 
results. Therefore, while the Mentzer Index can guide 
initial diagnosis and management, it must be used 
alongside other diagnostic tests, such as serum ferritin 
levels, hemoglobin electrophoresis, or genetic testing, to 
confirm the cause of anemia and guide appropriate 
treatment.10-11 

Interpretation of the Mentzer Index 

The Mentzer Index is a simple, cost-effective tool used 
to help differentiate between iron deficiency anemia 
(IDA) and thalassemia trait (TT), particularly in cases 
where anemia is suspected during pregnancy. It is based 
on the relationship between two key laboratory 
parameters: the mean corpuscular volume (MCV) and 
the red blood cell (RBC) count. 

The interpretation of the Mentzer Index depends on the 
value obtained from the calculation: 

1. Mentzer Index > 13: A value greater than 13 is 
typically suggestive of iron deficiency anemia 
(IDA). This is because iron deficiency leads to 
microcytic anemia, where red blood cells are smaller 
than normal (low MCV), and the RBC count is usually 
reduced. Since iron is crucial for hemoglobin 
production, low iron levels lead to fewer and smaller 
red blood cells. A higher index value indicates that 
the reduction in RBC count is more pronounced than 
the reduction in MCV, a hallmark of IDA.12 

2. Mentzer Index < 13: A value less than 13 generally 
points to thalassemia trait (TT). Thalassemia is a 
genetic disorder that results in abnormal 
hemoglobin production, leading to microcytic 
anemia. However, unlike IDA, thalassemia trait is not 
due to iron deficiency, and RBC count may be normal 
or even slightly elevated. In TT, the reduction in MCV 

is greater than the reduction in RBC count, which is 
reflected in a lower Mentzer Index.13 

3. Mentzer Index between 13 and 16: Values within 
this range can be more ambiguous and may indicate 
a need for further testing. In cases of mixed anemia 
(such as coexisting IDA and thalassemia trait), the 
result might fall between these two thresholds. 
Additionally, certain conditions like chronic 
inflammation or anemia of chronic disease can 
complicate the interpretation of the Mentzer Index.14 

Clinical Use of the Mentzer Index 

The Mentzer Index is typically used as a screening tool 
to help clinicians distinguish between IDA and TT 
before ordering more expensive or invasive diagnostic 
tests. It is particularly useful in resource-limited settings 
where access to sophisticated diagnostic techniques like 
hemoglobin electrophoresis or genetic testing may be 
restricted. However, the Mentzer Index should not be 
used in isolation. It serves as an initial step in the 
diagnostic process, which should be followed by 
confirmatory tests to ensure accurate diagnosis. In the 
context of pregnancy, the Mentzer Index can help avoid 
the unnecessary administration of iron supplements to 
women with thalassemia trait, as they do not benefit 
from such treatments and iron supplementation may 
lead to iron overload. Early and accurate differentiation 
between IDA and 15 

Application of the Mentzer Index in Pregnancy 

Pregnancy is a critical period during which anemia, 
particularly iron deficiency anemia (IDA) and 
thalassemia trait (TT), can have significant 
consequences for both maternal and fetal health. The 
Mentzer Index plays an essential role in helping 
clinicians differentiate between these two common 
causes of anemia, thereby guiding appropriate 
treatment strategies. By calculating the ratio of mean 
corpuscular volume (MCV) to red blood cell (RBC) 
count, the Mentzer Index offers a quick and simple 
method to assess whether anemia is due to iron 
deficiency or thalassemia, which require distinctly 
different management approaches.16 During pregnancy, 
the increased demand for iron to support the growing 
fetus, the placenta, and the expanded blood volume can 
lead to iron deficiency, resulting in IDA. Women with 
IDA may experience fatigue, weakness, and an increased 
risk of complications, including preterm delivery, low 
birth weight, and impaired fetal development. The 
Mentzer Index can aid in the early identification of IDA 
by identifying a high index value (>13), indicating a 
reduced RBC count relative to the MCV. This is a typical 
feature of iron deficiency, where the production of red 
blood cells is limited by insufficient iron, resulting in 
smaller and fewer red blood cells. Prompt identification 
of IDA allows for the timely initiation of iron 
supplementation, which is critical in improving 
maternal and fetal health outcomes.17 

On the other hand, thalassemia trait (TT), a genetic 
disorder that results in abnormal hemoglobin 
production, is prevalent in certain regions and can be 
mistaken for IDA due to overlapping symptoms, such as 



Emmanuel Ifeanyi Obeagu                                                                                                        Asian Journal of Dental and Health Sciences. 2025; 5(1):5-10 

[7]                                                                                                                                                                                                                                              AJDHS.COM 

microcytic anemia and low hemoglobin. However, 
unlike IDA, thalassemia is not caused by a lack of iron 
and does not respond to iron supplementation. The 
Mentzer Index is particularly useful in differentiating TT 
from IDA by providing a value less than 13, which 
suggests that the reduction in MCV is greater than the 
reduction in RBC count—characteristic of thalassemia 
trait. Thalassemia trait can lead to mild anemia but does 
not require iron supplementation and may instead 
require genetic counseling and monitoring to avoid 
unnecessary iron therapy, which can lead to iron 
overload and further complications.18 Pregnant women 
with thalassemia trait may face a higher risk of 
complications, such as preeclampsia, growth restriction, 
and fetal anemia, if the condition is not appropriately 
identified and managed. Using the Mentzer Index to 
screen for thalassemia trait allows healthcare providers 
to make more accurate diagnoses and provide 
appropriate care. The Mentzer Index enables the 
differentiation between IDA and TT, offering a non-
invasive and cost-effective approach to identifying the 
underlying cause of anemia in pregnancy, particularly in 
areas where access to advanced diagnostic methods like 
hemoglobin electrophoresis may be limited.19 Although 
the Mentzer Index is a useful screening tool, it should 
not be used in isolation. The index’s accuracy can be 
influenced by factors such as mixed anemia, 
inflammation, and concurrent medical conditions. For 
example, pregnant women may experience anemia due 
to factors such as folate deficiency or anemia of chronic 
disease, which may not be distinguished accurately 
using the Mentzer Index alone. Therefore, while the 
Mentzer Index serves as an essential first step, further 
confirmatory testing, including serum ferritin levels, 
hemoglobin electrophoresis, or genetic testing, is 
necessary for a definitive diagnosis.20 

Benefits of the Mentzer Index in Anemia 
Diagnosis 

The Mentzer Index provides several advantages in the 
diagnosis of anemia, especially in distinguishing 
between iron deficiency anemia (IDA) and thalassemia 
trait (TT), two common causes of microcytic anemia. 
The primary benefits of using the Mentzer Index in 
anemia diagnosis are its simplicity, cost-effectiveness, 
accessibility, and efficiency in guiding further diagnostic 
and treatment decisions.21 Below are the key benefits of 
utilizing the Mentzer Index: 

1. Simplicity and Ease of Use 

One of the major advantages of the Mentzer Index is its 
simplicity. The calculation requires only two basic 
laboratory parameters: mean corpuscular volume 
(MCV) and red blood cell (RBC) count. These values are 
routinely measured in standard complete blood count 
(CBC) tests, which are commonly available in most 
healthcare settings. The formula for calculating the 
Mentzer Index is straightforward, making it easy for 
clinicians to apply without the need for complex 
equipment or additional tests. This simplicity allows for 
quick decision-making in clinical practice, especially in 
settings with limited resources.22 

2. Cost-Effectiveness 

The Mentzer Index is an affordable diagnostic tool. 
Unlike more advanced diagnostic methods, such as 
hemoglobin electrophoresis or genetic testing, which 
can be expensive and may not be accessible in resource-
limited areas, the Mentzer Index relies on widely 
available and low-cost tests, such as the CBC. In settings 
where advanced diagnostic tools are not readily 
available, the Mentzer Index can serve as a crucial first 
step in diagnosing anemia and guiding treatment 
decisions. This makes it a particularly valuable tool in 
low-income or developing regions where cost-effective 
healthcare solutions are essential.23 

3. Quick and Efficient Differentiation 

One of the most significant benefits of the Mentzer Index 
is its ability to quickly and effectively differentiate 
between IDA and thalassemia trait (TT), which require 
different treatment strategies. IDA is caused by 
insufficient iron, while TT is a genetic condition that 
does not respond to iron supplementation. The Mentzer 
Index allows healthcare providers to identify which 
condition is most likely, enabling early intervention. For 
instance, if the index is greater than 13, IDA is more 
likely, prompting the administration of iron 
supplements. Conversely, a value below 13 typically 
suggests TT, avoiding the unnecessary and potentially 
harmful iron supplementation. This rapid 
differentiation ensures that the appropriate treatment is 
started without delay.24 

4. Helps Avoid Misdiagnosis and Unnecessary 
Treatments 

The Mentzer Index is particularly useful in preventing 
the misdiagnosis of anemia, which is common due to the 
overlap in symptoms of IDA and TT, such as fatigue and 
low hemoglobin levels. If thalassemia trait is 
misdiagnosed as IDA, patients may be prescribed iron 
supplements, which will not only be ineffective but can 
also lead to iron overload, causing further complications 
such as organ damage. By distinguishing between these 
two causes of anemia, the Mentzer Index helps avoid 
unnecessary iron therapy and ensures that patients 
receive the correct management. This leads to better 
patient outcomes by preventing the risks associated 
with inappropriate treatments.25 

5. Supports Early Detection in Pregnancy 

Pregnancy is a time when anemia is common, and 
accurate diagnosis is essential to prevent complications 
for both the mother and fetus. The Mentzer Index is 
particularly beneficial in pregnancy, where iron 
deficiency anemia is prevalent, but thalassemia trait is 
also a concern, especially in regions with high carrier 
rates. It enables healthcare providers to promptly 
identify the cause of anemia and provide appropriate 
care. For example, in pregnant women diagnosed with 
IDA based on the Mentzer Index, iron supplementation 
can be started to improve maternal and fetal health. In 
contrast, if thalassemia trait is identified, iron 
supplementation can be avoided, and further genetic 
counseling can be provided as needed.26 



Emmanuel Ifeanyi Obeagu                                                                                                        Asian Journal of Dental and Health Sciences. 2025; 5(1):5-10 

[8]                                                                                                                                                                                                                                              AJDHS.COM 

6. Aids in Clinical Decision-Making and Resource 
Allocation 

The Mentzer Index assists clinicians in making informed 
decisions quickly, leading to better clinical outcomes. By 
providing an initial guide for whether anemia is likely 
due to iron deficiency or thalassemia trait, the index can 
help prioritize further testing or treatment. This is 
especially helpful in resource-limited settings where 
healthcare resources may be scarce, and prioritizing the 
most likely cause of anemia is necessary. Additionally, 
the index can guide the appropriate allocation of 
resources, ensuring that treatments, such as iron 
supplementation or genetic counseling, are directed to 
the right patients.27 

Limitations and Challenges of the Mentzer 
Index 

While the Mentzer Index offers numerous benefits in 
anemia diagnosis, it is not without its limitations and 
challenges. These limitations may affect its accuracy and 
the appropriateness of its use in certain clinical 
scenarios. Below are the key limitations and challenges 
associated with the Mentzer Index: 

1. Influence of Mixed Anemia 

The Mentzer Index is most effective in distinguishing 
between iron deficiency anemia (IDA) and thalassemia 
trait (TT), but it may not perform well in cases where a 
patient has mixed anemia. Mixed anemia occurs when a 
patient has two or more underlying causes of anemia, 
such as IDA coexisting with vitamin B12 or folate 
deficiency, or anemia of chronic disease. In such cases, 
the calculation of the Mentzer Index may fall within a 
range that does not accurately reflect the primary cause 
of anemia. For instance, a patient with both IDA and 
thalassemia trait could present with a Mentzer Index 
value that lies within the range for mixed anemia, 
leading to potential misclassification. This limitation 
emphasizes the need for additional testing and clinical 
judgment.20 

2. Impact of Inflammation and Other Co-
morbidities 

The presence of chronic inflammation, infection, or 
other co-morbidities can skew the results of the 
Mentzer Index. Conditions such as chronic kidney 
disease, autoimmune diseases, or active infections can 
affect red blood cell production, alter MCV, and even 
change RBC count. In such cases, the Mentzer Index may 
not provide an accurate reflection of the underlying 
anemia etiology. For example, inflammatory responses 
may lead to anemia of chronic disease, which typically 
presents with low MCV, resembling the presentation of 
IDA. Thus, the presence of other health conditions could 
lead to false positives or false negatives when 
interpreting the Mentzer Index, highlighting the need 
for a broader clinical evaluation.21 

3. Limited Accuracy in Certain Populations 

The Mentzer Index is most effective when used in 
populations with a high prevalence of thalassemia trait 
and iron deficiency anemia, such as in regions where 

these conditions are common. However, in populations 
where other forms of anemia (e.g., anemia due to folate 
deficiency, vitamin B12 deficiency, or 
hemoglobinopathies other than thalassemia) are more 
prevalent, the Mentzer Index may be less reliable. 
Additionally, its use in pregnant women or other 
populations with altered hematologic parameters may 
not always yield accurate results, as pregnancy-related 
anemia often has multiple contributing factors, 
complicating the interpretation of the index. In these 
cases, further confirmatory testing, such as serum 
ferritin, hemoglobin electrophoresis, or genetic testing, 
is needed to make a definitive diagnosis.22 

4. Difficulty in Identifying Other 
Hemoglobinopathies 

While the Mentzer Index is useful for distinguishing 
between IDA and thalassemia trait, it is less effective in 
identifying other hemoglobinopathies or genetic 
conditions that cause microcytic anemia, such as 
hemoglobin E, hemoglobin D, or sickle cell trait. These 
conditions may present with similar hematologic 
features to thalassemia trait, yet they are not 
differentiated by the Mentzer Index. As a result, patients 
with other hemoglobinopathies may be misdiagnosed, 
leading to suboptimal treatment. This underscores the 
limitation of the Mentzer Index as a screening tool for a 
broader spectrum of inherited blood disorders, 
necessitating additional tests for comprehensive anemia 
diagnosis.23 

5. Variability in Laboratory Parameters 

The accuracy of the Mentzer Index depends on the 
reliability of the MCV and RBC count, both of which can 
vary due to laboratory equipment, technique, or errors 
in sample handling. Variability in laboratory results can 
lead to inaccurate Mentzer Index calculations, which 
may in turn affect clinical decision-making. For instance, 
if MCV or RBC count is mismeasured due to poor sample 
quality or technical issues, the Mentzer Index may not 
reflect the true underlying cause of anemia, leading to 
potential misclassification. Consequently, it is important 
to ensure that laboratory tests are performed accurately 
and consistently to maximize the value of the Mentzer 
Index.26 

6. Over-reliance on a Single Diagnostic Tool 

Another challenge is the tendency for clinicians to over-
rely on the Mentzer Index as a definitive diagnostic tool, 
without considering other important factors or clinical 
context. While the Mentzer Index is useful as an initial 
screening tool, it should not be the sole determinant in 
diagnosing anemia. It is important to integrate the index 
with other diagnostic tests, patient history, physical 
examination, and clinical judgment. An over-reliance on 
the Mentzer Index may lead to diagnostic oversights, 
especially in complex cases where multiple factors 
contribute to anemia.27 

Conclusion 

The Mentzer Index is a valuable and cost-effective tool 
for differentiating between iron deficiency anemia and 
thalassemia trait, two common causes of microcytic 



Emmanuel Ifeanyi Obeagu                                                                                                        Asian Journal of Dental and Health Sciences. 2025; 5(1):5-10 

[9]                                                                                                                                                                                                                                              AJDHS.COM 

anemia. Its simplicity, ease of calculation, and 
accessibility make it an attractive first-line diagnostic 
approach, particularly in resource-limited settings. 
However, the tool has limitations, including its reduced 
accuracy in cases of mixed anemia, the influence of 
inflammation or co-morbidities, and its inability to 
identify other hemoglobinopathies. Furthermore, 
laboratory variability and the potential for over-reliance 
on a single diagnostic parameter highlight the 
importance of integrating the Mentzer Index with a 
comprehensive clinical evaluation. Despite these 
challenges, when used as part of a broader diagnostic 
strategy, the Mentzer Index remains a crucial aid in 
anemia management, helping to guide treatment 
decisions and improve patient outcomes, particularly in 
populations with high rates of iron deficiency and 
thalassemia. Ultimately, a multifaceted approach that 
includes clinical judgment, additional laboratory tests, 
and patient history is essential for accurate anemia 
diagnosis and management. 

Conflict of Interest: Author declares no potential 

conflict of interest with respect to the contents, 

authorship, and/or publication of this article. 

Source of Support: Nil 

Funding: The authors declared that this study has 

received no financial support. 

Informed Consent Statement: Not applicable.  

Data Availability Statement: The data supporting in 

this paper are available in the cited references.  

Ethics approval: Not applicable. 

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Emmanuel Ifeanyi Obeagu                                                                                                        Asian Journal of Dental and Health Sciences. 2025; 5(1):5-10 

[10]                                                                                                                                                                                                                                              AJDHS.COM 

22. Obeagu EI, Obeagu GU. Mitigating Oxidative Stress in Pregnancy 
through Antioxidant Supplementation: A Narrative Review. Int. J. 
Curr. Res. Chem. Pharm. Sci. 2024;11(9):7-17. 

23. Obeagu EI, Obeagu GU. Enhancing Maternal and Fetal Well-being: 
The Role of Antioxidants in Pregnancy. Elite Journal of Medical 
Sciences. 2024;2(4):76-87. 

24. Obeagu EI, Obeagu GU. Antioxidant Supplementation and 
Prevention of Early Pregnancy Loss: A Narrative Review. Int. J. 
Curr. Res. Chem. Pharm. Sci. 2024;11(9):28-37. 
https://doi.org/10.22270/ijmspr.v10i4.120 

25. Obeagu EI, Obeagu GU. Molar Pregnancy: Update of prevalence and 
risk factors. Int. J. Curr. Res. Med. Sci. 2023;9(7):25-28. 
https://doi.org/10.19080/JGWH.2023.25.556169 

26. Obeagu EI, Obeagu GU. Hypoxia-induced Metabolic Changes in 
Pregnancy: Clinical Perspectives. Elite Journal of Medicine. 
2024;2(8):50-59. 

27. Obeagu EI, Obeagu GU. Hemolysis Challenges for Pregnant Women 
with Sickle Cell Anemia: A Review. Elite Journal of Haematology. 
2024;2(3):67-80.

 

 

https://doi.org/10.22270/ijmspr.v10i4.120
https://doi.org/10.19080/JGWH.2023.25.556169

