Liskovskyy S. Clinical-laboratory estimation of pregnancy course and prophylaxis of gestational complications for women with cyanocobalamin deficit

The research purpose was improvement of complex prophylaxis of obstetric and perinatal complications for women with the cyanocobalamin deficit on the basis of complex clinical-laboratory estimation of pregnancy course, estimation of fetoplacental complex status and by the differentiated application of therapy depending on the genotype features of woman. The tables of vitamin В12 level in blood below the lower limit of reference values were diagnosed in 575 (60.0%) of pregnant women of the Central area of the Odessa region. The pregnancy course at В12 hypovitaminosis was accompanied with anaemia in 52 (57.3%), preeclampsia - 52 (57.3%), fetoplacental circulation disturbances - 30 (33.3%), placental dysfunction - 65 (72.2%), fetal growth retardation (FGR) syndrome - 24 (26.7%), chronic fetal hypoxia - 42 (46.7%) clinical cases. Frequency of polymorphism of gene of methylene tetrahydrofolate reductase at pregnant women with В12 hypovitaminosis made 87.8%; the chances ratio value for gestation complications development was 1.5. The concentration of homocystein at pregnant women with В12 hypovitaminosis was as high as 2.8 times, folic acid and cyanocobalamin - as small as 2.8; 2.3 times. The offered measures contributed to reduce the frequency of pathological types of fetoplacental complex hormonal reaction 3.5 times, homocystein level - 1.8 times; to increase the level of folic acid and vitamin В12 - 1.3 times; to reduce the signs of gestational anemia - 2.2 times, placental dysfunction - 3.7 times, FGR syndrome - 10.0 times, chronic fetal distress - 5.7 times.