الفهرس 
Pre-eclampsia
Chronic hypertensionOnly 14 pages are availabe for public view
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Abstract
Preeclampsia is a pregnancy-specific disorder that affects 3–
5% of pregnant women worldwide and is one of the most
frequently encountered medical complication of pregnancy.
Hypertension is one of the most common medical
complications of pregnancy. It remains one of the leading
causes of maternal deaths all over the world. Early detection
and appropriate management of the pregnancy may improve
the outcome for both the mother and the fetus .
Despite growing knowledge of the pathophysiology of
pregnancy induced hypertensive disorders, there is no
preventive measures have been shown to be effective.
Recent research has pointed towards some role of
vitamin D deficiency in pathogenesis of preeclampsia. Vitamin
D deficiency in pregnant women and their children is a major
health problem, with potential adverse consequences for overall
health.
Vitamin D deficiency correlates with many other
adverse effects such as infertility, gestational diabetes
mellitus, bacterial vaginosis, preterm labour, low birth
weight and an increased risk for cesarean delivery.During pregnancy and lactation, significant changes in
maternal vitamin D and calcium metabolism occur to
provide the calcium that is needed for fetal bone mineral
accretion.
Compared to normal pregnancies, vitamin D
metabolism is markedly altered in pre-eclampsia. This may
be due to reduced placental 1α-hydroxylase activity resulting
in lower circulating calcitriol concentrations compared to
normotensive pregnant women.
Vitamin D inhibits the mRNA transcription of
inflammatory cytokine genes (TNFα, IFNγ and IL-6) in
trophoblast cell. Immune challenge by lipopolysaccharide
induces the expression of VDR and CYP27B1 along with
cytokines such as IL-6 in placenta.
The increase in the number of studies on this subject
shows conflicting results on the association between
25(OH)D levels in pregnancy and adverse effects on
maternal and fetal health, both skeletal and non-skeletal such
as autoimmune diseases, cardiovascular diseases, diabetes
and certain types of cancer.
The current study aimed to compare Serum 25 hydroxy
vitamin D levels among patients with preeclampsia and healthy
normotensive pregnant women. A case-control study was conducted at Ain Shams
University Maternity Hospital as 90 primigravida women,
between 18-35 years, with Singleton pregnancy, after 36
weeks of gestation without any other medical disorders. They
were classified into 2 groups:
- group (1): 45 preeclamptic women.
- group (2): 45 normotensive women.
Preeclampsia was defined as a systolic blood pressure
greater than or equal to 140 mm Hg and/or diastolic blood
pressure greater than or equal to 90 mmHg and the presence
of +1 or more of proteinuria after 20 weeks of gestation.
Deficiency of vitamin D level in pregnant women was
defined as serum level < 20 ng/ml, insufficiency as 21-30 ng/ml
and optimum level as > 30 ng/ml.
All samples were screened by DRG® 25-OH Vitamin D
(total) ELISA (EIA-5396) and it was found that mean 25
hydroxy vitamin D levels were lower in preeclamptic group
than normotensive control group. Mean level of 25 hydroxy
vitamin D between preeclamptic cases was 11.98 ±5.43 ng/ml
and between normotensive controls was12.33± 10.48 ng/ml So, according to student T test and chi-square test, the
current study hypothesized that there is no significant
difference in serum 25 hydroxy vitamin D levels between
preeclamptic and control normotensive group.
In conclusion, from this study it can be concluded that
vitamin D assay can not be used for prediction of
preeclampsia and vitamin D supplementation can not be
routinely used in prevention of preeclampsia.