Kharakterystyka klinichno-laboratornykh pokaznykiv vmistu mahniiu u syrovattsi krovy vahitnykh iz rannim hestozom riznoho stupenia tiazhkosty

Abstract

Introduction. Early gestosis is a pathological pregnancy state linked to the development of a fertilized egg or its elements and is characterized by several symptoms. In today’s conditions, the frequency of early gestosis is observed in 60.0-80.0 % of pregnant women, and the need for hospitalization and special treatment occurs in 12.0-17.8 % of pregnant women. According to statistics, up to 90.0 % of pregnant women suffer from nausea and vomiting of varying severity. One of the main issues of medical care for pregnant women with early preeclampsia, in addition to the number of episodes of vomiting during the day, is the presence and severity of micronutrient and vitamin imbalance, which should be inevitable due to nutritional deficiencies due to incontinence and loss of micronutrients with vomiting. One of the key moments of vomiting in pregnant women is expressed misbalance in microelements, especially magnesium (Mg). Mg is necessary for vitamin D biosynthesis, transportation, and activation which is one of the key factors determining the effectiveness of our immune system. Mg participates in vitamin D metabolism, normalizes it, and increases the sensitivity of the target organs. Magnesium has a significant role in immune response as a cofactor for immunoglobulin synthesis and other processes associated with T- and B-cells function is a natural antistress factor that slows down excitation of the central nervous system. The prospects of magnesium insufficiency influencing the severity of early gestosis are poorly studied, which became the reasoning for this study. The aim of the study. To characterize clinical and laboratory indices of magnesium levels in blood serum in pregnant women with early gestosis of different severity grades. Materials and methods. We examined 150 women, 100 ones (the main group) with signs of early gestoses: 41 females with mild signs, 37 women with moderate signs, 22 ones with severe signs, and 50 females (the control group) with the physiologic course of the first trimester of pregnancy. We considered the patient’s complaints, information from case history, physical examination data, common laboratory tests, and ultrasound imaging. The evaluation of Mg deficit was performed according to an adapted standardized score that was used in the international medical practice according to the scale of deficit signs and the Mg levels in blood serum were tested. The reference values of normal Mg levels in blood serum were 0.80-0.85 mmol/L. The statistical analysis of the results was performed using methods of variability with the help of MS Excel and Statistica SPSS10.0 for Windows. Results. According to the results of the questionnaire, the women from the main group mostly presented the Mg deficit and only 17 (17.0%) of pregnant females had no Mg deficit; at the same time, the pregnant women presented Mg insufficiency in 7 (14.0%), and Mg deficit was observed only in 1 (2%) case. the gotten results showed that at increasing gestosis severity, Mg deficit frequency in blood serum increases as well. The analysis of Mg indices in blood serum and using the questionnaire for Mg deficit allowed the determination significant prevalence of magnesium deficit. Conclusion. Most women aged 18-40 years with single live intrauterine pregnancy at 4-12 weeks and signs of early gestosis present magnesium insufficiency and deficit and the frequency of such cases increases with higher severity of early gestosis.