Hidden role of hypovitaminosis and micronutrient deficiency in pregnancy pathology development in recent years become the subject of study of various specialists, but poorly understood combined prevalence of vitamin D deficiency and magnesium. The aim of study was to evaluate the prevalence of vitamin D deficiency and hypomagnesemia among pregnant women with threatened miscarriage, complicated by retrohorial hematoma.
The study included 160 patients with the threat of abortion. The main group consisted of 90 pregnant women in the period of gestation from 6 to 12 weeks with retrochorial hematoma, a comparison group of 70 women with a risk of abortion without hematoma, a control group of 50 conditionally healthy pregnant women in similar gestational periods. Ultrasonographic examination was performed on the HDI 5000 Sono CT (Philips Ultrasound, USA) according to the standard procedure. Criteria for the threat of abortion during ultrasound examination were cervical shortening, asymmetry of the uterus, deformation of the fetal egg, and the presence of retrochorial hematoma. The level of 25(OH)D in serum was determined by immunochemical chemiluminescent detection (Architect i2000 analyzer, ABBOT Diagnostics test system), magnesium level in venous blood, by colorimetric method (Roche Diagnostics test systems (Switzerland), Sobas 6000 analyzer). Sufficient provision of vitamin D was considered to be 25(OH)D level in blood serum of 30-50 ng/ml, insufficiency – 20-29 ng/ml, deficit – 19 ng/ml and less.
Sufficient supply of vitamin D (level 25(OH)D in blood 31.5 ± 1.8 ng/ml) was only 5.6 % of women in main group and 8.6 % – in comparison groups. The prevalence of vitamin D deficiency (25(OH)D 22.6 ± 1.3 ng/ml) in the main and comparative groups was 32.2 % and 48.6 % respectively (p < 0.001 compared to control), then as deficiency of vitamin D (level 25(OH)D 12.8 ± 4.6 ng/ml) was found in 62,2 % of pregnant women in the main group and 42,9 % in comparison groups (p = 0,0142) in the absence of women control group. The analysis of levels of magnesium in serum (0.72 ± 0.22 mmol/l) in the women of the main, comparison group and the control group (0.74 ± 0.18 mmol/l) showed a lack of significant difference in rates (p > 0.05), while the use of the questionnaire to determine the deficit of magnesium allowed to establish a significant prevalence of magnesium deficiency. In women of main group, the prevalence of moderate deficiency of magnesium was 36.7 % of cases (average score 21.7 ± 2.3), and in 5.6 % of pregnant women, the score corresponded to a deficit of magnesium (28-34 points). Similar results were obtained when comparing the pregnant women in the comparison group (p > 0.05). Violation of the micronutrient and vitamin balance due to the risk of complications of pregnancy from early gestational periods requires appropriate correction from the preconception stage, and the development of the principles of correction of these states and the evaluation of their effectiveness should be the basis for further research.
Keywords: miscarriage, retrohorial hematoma, deficiency of vitamin D, magnesium deficiency
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