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Management If B Deficiency Is Confirmed Oral cyanocobalamin: 10002000 g daily or IM hydroxocobalamin: Loading: 1 mg weekly for 46 weeks Maintenance: 1 mg every 23 months Metformin should usually be continued Supplement B rather than stopping metformin 7

Inadequate CL function now stands recognized as a leading cause of serious pregnancy complications which also include preterm birth together with intrauterine growth restriction (IUGR) (186)