Meena Seema, Gaikwad Harsha S, Nath Banashree
Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rae Bareli, IND.
Cureus. 2023 Mar 1;15(3):e35664. doi: 10.7759/cureus.35664. eCollection 2023 Mar.
Background Out of the many causes of abruptio placentae, the micronutrient association with its occurrence and severity has not been researched extensively till now. We aim to measure the serum levels of homocysteine, folic acid and vitamin B12 in patients with abruptio placentae in the third trimester of pregnancy and compare the levels with those without the complication. We also propose to compare the feto-maternal outcome between the groups. Methods The cross-sectional study was undertaken in 50 pregnant women with abruption before or during delivery and 50 controls with uncomplicated pregnancy over 28 weeks of gestation. Serum levels of homocysteine, folic acid, and vitamin B12 were determined and feto-maternal outcome was compared between the groups Results Mean age of the cases and controls are 26.82 ± 5.5 and 28.82 ± 4.88 years respectively. Obstetric characteristics have significant difference between the groups in terms of gravidity, mode of delivery, timing of delivery, proportion of stillbirths and blood transfusion. The mean concentration of homocysteine and vitamin B12 between the groups also have a significant difference . The serum level of homocysteine is significantly correlated with serum vitamin B12 level (Pearson correlation= -0.601, P=0.000). However, folic acid concentration between the groups remains comparable. Conclusion Hence we conclude that vitamin B12 and homocysteine are significant determinants of abruptio placentae in pregnant women. Supplementation with the vitamin in the high-risk Indian population can avert a number of obstetric complications occurring due to raised homocysteine.
在胎盘早剥的诸多病因中，微量营养素与其发生及严重程度之间的关联至今尚未得到广泛研究。我们旨在测定妊娠晚期胎盘早剥患者血清中同型半胱氨酸、叶酸和维生素B12的水平，并与无该并发症的患者进行比较。我们还打算比较两组间的母婴结局。方法：对50例分娩前或分娩时发生胎盘早剥的孕妇和50例妊娠超过28周无并发症的孕妇进行横断面研究。测定血清中同型半胱氨酸、叶酸和维生素B12的水平，并比较两组间的母婴结局。结果：病例组和对照组的平均年龄分别为26.82±5.5岁和28.82±4.88岁。两组在妊娠次数、分娩方式、分娩时间、死产比例和输血方面的产科特征存在显著差异。两组间同型半胱氨酸和维生素B12的平均浓度也存在显著差异。血清同型半胱氨酸水平与血清维生素B12水平显著相关（Pearson相关系数=-0.601，P=0.000）。然而，两组间叶酸浓度相当。结论：因此我们得出结论，维生素B12和同型半胱氨酸是孕妇胎盘早剥的重要决定因素。在印度高危人群中补充该维生素可避免因同型半胱氨酸升高而发生的许多产科并发症。
