Abstract:
Preeclampsia (PE) of pregnant women continues to be one of the leading causes of maternal and
perinatal morbidity and mortality, and the existing theories about the pathogenetic mechanisms of its
development are not absolutely convincing. To take into account the data on the pleiotropic effects of
vitamin D (VD) and its effect on reproductive function, we set a purpose to study the relationship
between hemodynamic parameters in the uterine arteries and the level of VD in the blood of women at
risk of PE developing.
Materials and methods. From 2018 to 2021, 54 women with a risk of PE developing and VD
insufficiency were under observation. A cross-sectional examination was carried out at the 1st trimester
of pregnancy. Blood content of VD (25 (OH) D) was determined on an empty stomach by ELISA on a
CobasIntegra 400 Plus analyzer (Roche Diagnostics, Switzerland). Measurement of the pulsation index
in the uterine arteries (PI in UA) was done according to the recommendations of the Fetal Medicine
Foundation (FMF) on an ultrasound apparatus "VOLUSON 730 EXPERT" (2008); volumetric convex
intracavitary (RIC 5-9) and volumetric multifrequency convex probes (RAB 4-8P) were used.
Results and discussion. The mean age of the women under examination was 28.4 ± 4.9 y.o.; there
were 64.8% of primiparas; 62.9% of women were 25 y. o. and over; 92.6% of pregnant women were
overweight or had obesity of various degrees; 72.5% of them had various extragenital pathologies. (25
(OH) D) mean level was 25.8 ± 7.3 ng / ml; the mean PI in UA was 1.98 ± 0.504. There were 19 pregnant
women with PI in UA ranging > 50 and <95 percentile (35.19%), in every fifth woman (11 patients or -
20.4% ) resistance in MA exceeded 95 percentile. A significant negative statistical relationship was
established between VD level in the blood and PI value in UA (rs = -0.734; P <0.01).
Conclusions. Pregnant women with a high risk of PE development has pathologically increased
resistance in the uterine vessels already in the first trimester of pregnancy. A strong inverse
relationship was found between the level of vitamin D in the blood of high-risk pregnant women and
indicator of impedance in the uterine arteries. Timely diagnosis and correction of vitamin D deficiency
in women of reproductive age at the stage of preconception training can be a promising direction in
the prediction and prevention of perinatal morbidity and mortality.
All human studies were conducted in compliance with the rules of the Helsinki Declaration of the
World Medical Association "Ethical principles of medical research with human participation as an object
of study". Informed consent was obtained from all participants.
