The value of determining concentrations of calcidiol and vascular endothelial growth factor to predict non-developing pregnancy
Background: Non-developing pregnancy is one of the most difficult medical and social problems of modern obstetrics and gynecology, which has no tendency to decrease. Previously occurred non-developing pregnancy is a predictor of adverse outcomes of subsequent pregnancies, up to the usual miscarriage. Non-developing pregnancy is a multifactorial and polyetiological complication of gestation, which necessitates a comprehensive assessment of the probability of a pathological condition in each case. The aim of the study: Assessment of factors contributing to the formation of non-developing pregnancy to identify patients related to a risk group. Determining the status of vitamin D and plasma serum concentration of VEGF in patients with non-developing pregnancy as informative markers for predicting a pathological condition. Materials and methods: The study involved 116 patients: 76 patients with non-developing pregnancy and 40 patients with physiological pregnancy. The information about reproductive and somatic health of women, their social status was collected. The levels of neuroticism and anxiety were explored using the scale of Hake and Hess and the scale of Ch. D. Spielberg and Yu. L. Khanin. The types of accentuation of temperament were identified based on the G. Smishek and K. Leongard test results. The level of perinatal risk was determined using the scale of V. E. Radzinsky, S. A. Knyazev, I. N. Kostin (2011). The enzyme immunoassay 25-OH Vitamin D blood plasma was performed using a set of reagents ELISA, EUROIMMUN AG (Germany), VEGF - human VEGF-A ELISA using reagents from Thermo Fisher Scientific (USA). Results: The factors contributing to the development of the studied pathological condition were determined. Vitamin D deficiency has been found to be a risk factor for non-developing pregnancy. With a decrease of calcidiol concentration below 10 ng / ml in the plasma, the probability of developing a non-developing pregnancy increases by 4.74 times. The level of VEGF in patients with non-developing pregnancy is 5.1 times higher than in the control group. Conclusion: Determining the status of vitamin D and the concentration of VEGF is an additional diagnostic method to predict the likelihood of non-developing pregnancy. Identification of patients risking the development of non-developing pregnancy is possible with the help of a thorough history collection, clarification of social factors contributing to the emergence of a pathological condition and evaluation of psychoemotional status. For timely correction of hypovitaminosis, patients with a high risk of developing the studied complication of gestation are recommended to have their level of plasma calcidiol tested.