Conclusions
This case emphasizes the importance of generating a broad differential diagnosis for anaemia in pregnancy. Although SA is a rare type of anaemia, it should be considered in cases of unexplained pregnancy relapsing anemia. Specifying the type of SA is rather challenging as it requires extensive workup including deep genetic testing. However, careful review of the patient’s constellation of clinical findings and red cells indices and morphology aid in narrowing the differential diagnosis. Identification of possible revisable cause that can be treated as pyridoxin deficiency is crucial to ovoid both maternal and fetal adverse effect like prematurity, abortions, and even fetal death specially with Hb drop to a critical level.