Reference Values  During Pregnancy

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Mean corpuscular volume (MCV) (whole blood)

   Units Nonpregnant Adult First Trimester Second Trimester Third Trimester


79 -93 85 -97.8 85.8 - 99.4 82.4 - 100.4


79 -93 85 -97.8 85.8 - 99.4 82.4 - 100.4

Some causes of a low MCV include :

Iron deficiency, anemia of chronic disease, Shahidi-Nathan-Diamond syndrome, sideroblastic anemia,  thalassemias, and hemoglobinopathies.

Some causes of a high MCV include
  • Cobalamin (B12) deficiency due to strict vegetarianism, impaired absorption due to numerous conditions ( pernicious anemia, gastrectomy, celiac disease, scleroderma, lymphoma, etc.), parasites, hyperthyroidism, neoplastic disease, pancreatic disease, and enzyme deficiencies.
  • Folate deficiency from alcoholism , lack of vegetables, celiac disease, anticonvulsanats, oral contraceptives, hypothyroidism, infancy, neoplastic disease, exfoliative skin diseases, folic acid antagonists (trimethoprim, methotrexate, etc. ), and hemodialysis .
  • Metabolic inhibitors such as methotreaxte, enzyme deficiencies, Lesch-Nyhan syndrome and other inborn errors.
  • Mild macrocytosis can be seen during normal pregnancy in women who are not iron or folate deficient


1. Lockitch G. Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy. Boca Raton:CRC, 1993.
2. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol. 2009 Dec;114(6):1326-31. PMID:19935037
3. Fischbach FT, Dunning MB III, eds. A Manual of Laboratory and Diagnostic Tests, 7th ed. Philadelphia, Lippincott Williams and Wilkins,2004
4. Chanarin I, et al. The physiological macrocytosis of pregnancy.Br J Obstet Gynaecol. 1977 Jul;84(7):504-8.PMID:911706


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