Age-related relationship between the development of hyperplastic processes and VEGF expression in endometrial cells

The existence of a clear tendency to increase the prevalence of hormone-dependent diseases and endometrial cancer against the background of increasing the frequency of their occurrence and rejuvenation of the age of manifestation leads to the search for new possible markers of diagnosis and prognosis of the development of pathological process. Angiogenesis is one of the forms that lead to the formation of new blood vessels, with an increased metabolic need for perfusion of existing vessels. The vascular endothelial growth factor family (VEGF) is a protein that is the major inducer of angiogenesis. The objective: To study the expression of VEGF in endometrial cells in proliferative, hyperplastic, atrophic states at women’s different ages. Materials and methods. A retrospective analysis of medical records of the pathohistological bureau for the period 2014-2016 was conducted. 2196 pathomorphological findings of endometrial tissue specimens have been examined. Estimation of VEGF expression was performed in 417 endometrial specimens, in the cohorts of the study: in the reproductive, perimenopausal, postmenopausal periods, respectively, in groups with physiological endometrial proliferation phase, hyperplastic, atypical, atrophic endometrium. The results were statistically processed. Results and discussion. Analyzing the data presented, higher VEGF expression was detected in atypical hyperplasia in all age categories, but it was likely that higher rates were established in the postmenopausal period, with atypical endometrial hyperplasia, suggesting physicians' alertness to the process in this category. Probably low were indexes found at atrophic endometrium in this age category, which confirms the endometrial preservation of its growth factors, and in the presence of processes that stimulate the proliferation of the organ, they can trigger at the molecular-genetic level, neoplastic mechanisms. The data of the retrospective analysis confirm the growth of atypical form of hyperplastic processes and their maximum detection in the age categories 41 - 45  and 46 - 50 years old, and the beginning of detection of endometrial malignancy from the age of 46 - 50 years old, with a gradual increase with age. Conclusions. Expression of VEGF level in endometrial tissue cells as an inducer of angiogenesis can be a promising marker for the diagnosis of the risk of proliferative conditions and their prognosis, especially in relation to other markers characterizing immunohistochemical and molecular genetic cellular parameters

The retrospective analysis results of the endometrial tissue pathological conditions development

Hyperplastic processes of endometrium are one of the most common pathologies of the uterus mucosa, an interest in its study is due to an increase in the frequency of occurrence, the ability to both self-healing and malignancy. Purpose of the study: to investigate the detection rate of endometrial proliferative changes  depending on the age of woman. Materials and methods. A retrospective medical documentation analysis of the Department of Pathology was conducted. 2196 pathologic findings of endometrial tissue samples were investigated. 1404 specimen were hyperplastic states, 688 were endometrial polyps, and 104 others were endometrial states after total or subtotal uterine removal after surgery. Histological conditions were distributed according to patients’ age categories. Results of the study were processed statistically using variation statistics with Student's criterion, using standard computer systems. Results. The analysis shows an increase in frequency of endometrial proliferative changes in perimenopausal patients on the background of endometrial pathological changes detection in all age categories. Atypical forms of simple and complex hyperplasia of the endometrium can be traced in all age categories, with a maximum frequency of manifestation in similar age-related periods – 41–45 years and 46–50 years. Morphological signs of endometrial tissue malignancy were first established in the age group of 46–50 years, which coincides with the age of the onset of menopause in the Odesa region, with subsequent relative increase in the frequency and aggressiveness of the process with age. These age groups focus doctors to be more careful about pathological manifestations. Conclusion. As a result of retrospective analysis of histopathological examinations it was found that the main factor in detecting pathological conditions of the endometrium is a woman's age of perimenopausal period, which can be considered as an early marker of diagnosis, leading to treatment prospects and general therapeutic tactics, for the future diagnostics and detection of others immunohistochemical and molecular genetic markers in women with hyperplastic processes in endometrial tissue

ЕКСПРЕСІЯ МАРКЕРІВ ГІПОКСІЇ, АНГІОГЕНЕЗУ ЯК МІКРОЦИРКУЛЯТОРНО-ТКАНИННИХ ФАКТОРІВ У ПРОЛІФЕРАТИВНИХ ПРОЦЕСАХ ЕНДОМЕТРІЯ

The aim of the study – to learn the expression of VEGF and HIF-1α in physiological, hyperplastic, atypical endometrium at different ages of women. Materials and Methods. Evaluation of VEGF expression and HIF-1α performed in endometrial tissue samples in 458 women of late reproductive, perimenopausal and postmenopausal age. Expression of VEGF and HIF-1α was performed at the mRNA level by polymerase chain reaction of cDNA obtained by reverse transcription. The results were processed by the method of variation statistics with the assessment of reliability according to the Student's criterion using standard computer systems. Results and Discussion. Analyzing the data of the presented work, higher VEGF expression rates were found in atypical hyperplasia in all age categories, but probably higher rates were found in the postmenopausal period, in atypical endometrial hyperplasia, which indicates the need for vigilance in detecting this process in the appropriate age category. Studies have shown that HIF-1α can potentiate the activation of vasomotor genes that are required for the vascular response to hypoxia. These studies demonstrate the informativeness of the method of determining HIF-1α in the examination of patients with endometrial hyperplastic processes (EHP). The introduction of this method in practical medicine will not only understand the details of the changes occurring in the body (pathological, physiological), but also develop strategic maneuvers for possible therapeutic or surgical treatments. Conclusions. Expression of VEGF and HIF-1α levels in endometrial tissue cells as a marker can be a promising method for diagnosing the risk of proliferative conditions and their prognosis, especially in combination with other markers that characterize immunohistochemical and molecular genetic cellular parameters. Hypoxia and its relationship with indicators of angiogenesis may have some promising significance. Because the development of pathological conditions develops at a certain stage of hypoxic conditions. Under certain conditions, as a result of disruption of tissue processes, possibly metabolic, changes in angiogenesis are reduced with increasing hypoxia, which may in the long run provoke atypical disorders.Цель исследования – изучение экспрессии VEGF и HIF-1α в физиологическом, гиперпластическом и атипическом эндометрии в разные возрастные периоды женщины. Материалы и методы. Оценку экспресии VEGF и HIF-1α проводили в образцах эндометриальной ткани у 458 женщин позднего репродуктивного, перименопаузального и постменопаузального возраста. Экспрессию VEGF и HIF-1α проводили на уровне мРНК методом полимеразной цепной реакции кДНК, полученной методом обратной транскрипции. Результаты обработаны методом вариационной статистики с использованием критерия Стьюдента и стандартных компьютерных систем. Результаты исследования и их обсуждение. Анализируя данные представленной работы, были выявлены более высокие показатели экспрессии VEGF при атипической гиперплазии во всех возрастных категориях, вместе с тем, достоверно большие показатели были выявлены в постменопаузальном периоде, при атипической гиперплазии эндометрия, что свидетельствует о необходимости настороженности врачей при выявлении данного процесса в соответствующей возрастной категории. В исследованиях было установлено, что HIF может потенцировать активацию вазомоторных генов, которые необходимы для сосудистого ответа на гипоксию. Данные исследования демонстрируют информативность метода определения HIF-1α при обследовании пациентов с гиперплазией эндометрия (ГПЭ). Внедрение в практическую медицину данного метода позволит не только понять детали изменений, которые происходят в организме (патологических, физиологических), а и разработать стратегические маневры для возможного терапевтического или хирургического метода лечения. Выводы. Экспрессия уровня VEGF и HIF-1α в клетках эндометриальной ткани как маркера может быть перспективным методом диагностики риска развития пролиферативных состояний, а также их прогноза, особенно в комплексе соотношения с другими маркерами, которые характеризуют иммуногистохимические и молекулярно-генетические клеточные показатели. Гипоксия и ее соотношение с показателями ангиогенеза может нести определенное перспективное значение, так как при развитии патологических состояний на определенном этапе развивается гипоксическое состояние. При определенных состояниях, в результате нарушения тканевых процессов, возможно, метаболических, изменения в ангиогенезе уменьшаются при повышении гипоксии, что может в перспективе провоцировать атипичные нарушения.Мета дослідження – вивчити експресію VEGF та HIF-1α у фізіологічному, гіперпластичному, атиповому ендометрії в різні вікові періоди жінки. Матеріали та методи. Оцінку експресії VEGF та HIF-1α проводили в зразках ендометріальної тканини у 458 жінок пізнього репродуктивного, перименопаузального та постменопаузального віку. Експресію VEGF та HIF-1α проводили на рівні мРНК методом полімеразної ланцюгової реакції кДНК, отриманої методом зворотної транскрипції. Результати опрацьовані методом варіаційної статистики з оцінкою достовірності за критеріем Стьюдента з використанням стандартних комп’ютерних систем. Результати дослідження та їх обговорення. Аналізуючи дані представленої роботи, було виявлено вищі показники експресії VEGF при атиповій гіперплазії в усіх вікових категоріях, проте вірогідно вищі показники було встановлено в постменопаузальному періоді, при атиповій гіперплазії ендометрія, що свідчить про необхідність настороженості лікарів при виявленні даного процесу у відповідній віковій категорії. В дослідженнях було встановлено, що HIF може потенціювати активацію вазомоторних генів, які необхідні для судинної відповіді на гіпоксію. Дані дослідження демонструють інформативність методу визначення HIF-1α при обстеженні пацієнтів з гіперплазією ендометрія (ГПЕ). Впровадження в практичну медицину даного методу дозволить не лише зрозуміти деталі змін, що відбуваються в організмі (патологічних, фізіологічних), а й розробити стратегічні маневри для можливого терапевтичного або хірургічного методу лікування. Висновки. Експресія рівня VEGF та HIF-1α у клітинах ендометріальної тканини як маркера може бути перспективним методом діагностики ризику розвитку проліферативних станів та їх прогнозу, особливо в комплексі співвідношення з іншими маркерами, що характеризують імуногістохімічні та молекулярно-генетичні клітинні показники. Гіпоксія та її співвідношення з показниками ангіогенезу може нести певне перспективне значення, оскільки при розвитку патологічних станів на певному етапі настає гіпоксичний стан. При певних станах, в результаті порушення тканинних процесів, можливо, метаболічних, зміни в ангіогенезі зменшуються при підвищенні гіпоксії, що може в перспективі провокувати атипові порушення

Dynamic correlations in an ordered c(2×\times2) lattice gas

We obtain the dynamic correlation function of two-dimensional lattice gas with nearest-neighbor repulsion in ordered c(2$\times$2) phase (antiferromagnetic ordering) under the condition of low concentration of structural defects. It is shown that displacements of defects of the ordered state are responsible for the particle number fluctuations in the probe area. The corresponding set of kinetic equations is derived and solved in linear approximation on the defect concentration. Three types of strongly correlated complex jumps are considered and their contribution to fluctuations is analysed. These are jumps of excess particles, vacancies and flip-flop jumps. The kinetic approach is more general than the one based on diffusion-like equations used in our previous papers. Thus, it becomes possible to adequately describe correlations of fluctuations at small times, where our previous theory fails to give correct results. Our new analytical results for fluctuations of particle number in the probe area agree well with those obtained by Monte Carlo simulations.Comment: 10 pages, 7 figure

Innovative methods efficiency in obstetricians-gynecologists’ postgraduate education

Introduction: Important for the Ukraine was the creation of the new reformative governmental undergraduate and postgraduate medical education program. In Odessa State Medical University today it’s the main innovative guideline for the physician modern practical training especially in obstetrics and gynecology. Objective: To determine the efficiency of the innovative methods in the obstetricians-gynecologists postgraduate education. Materials and methods: The learning outcomes and assessment of 320 postgraduates of OB/GYN have been studied with the help of imitational virtual platforms for the obstetricians-gynecologists, birth simulators, virtual operation room and virtual labor room. Physicians’ average age was 39,4 ± 0,7 years; their average work experience - 12,6 ± 0,9 years. They underwent seminar (10%) and practical (90%) classes for the normal and pathological labor, obstetrical operations, urgent cases and emergencies in obstetrics with several different assessment protocols, including initial and final testing, anonymous self-assessment for their practical skills, structured check-lists with intermediate and final steps for each practical skill (from 12 to 18 points), team work with changing roles using video-monitoring and debriefing by case-study check-lists (29 positions; from 2 to 5 points for each). Results: According to the results of the final tests it was found that low initial assessment of complicated childbirth and obstetric surgery themes significantly increased one and a half times (р <0,001). After completion of the course the theoretical training was improved by one and a half times (р <0,05). Indicators of the output of the theoretical test of postgraduates with work experience of at least five years, compared with the postgraduates, the experience of more than fifteen years, were 1.3 times lower (р < 0,001). On the course completion the theoretical performance testing has increased one and a half times, and skills have increased twice. Initial assessment of the vacuum extraction newborn operation significantly increased almost twice (р <0,001). Teamwork evaluation at the end of the course has increased more than twice (р <0,001)

The basic laparoscopic skills long-term survival: new prediction scale

Introduction: The most important principle of pedagogy, including medical, is to correctly assess the knowledge and skills acquisition since they must be restored during the study and retained for use in further professional practice. Knowledge and skills in time survival are of particular importance in medicine since its determination allows to reveal the necessary time for repeated training and evaluate in general the medical education system efficiency. Objective: To develop a scale for predicting basic laparoscopy skills long-term survival in the medical education system. Materials and methods: The training results and assessment of 48 Odessa National Medical University medical students have been studied with the use of basic laparoscopy skills module of 3-D laparoscopy simulator trained as part of this module at the 5th year, forming a comparative group - CG (for obtaining initial mathematical prediction indicators), repeated it at the 6th year - forming the main group - MG (this group for the knowledge survival calculations and for reaching the main goal). They have passed all the module tasks, at least 10 trainings per module with the number of repetitions from 1 to 4. Time was recorded for the practical skills, security parameters, visual-motor coordination, the selection and release of devices, pedaling, diathermy, aspiration, irrigation, with a video camera viewing angle of 30° and 0°. The definition of the initial (1st training), intermediate (5th training) and the final (10th training) level of the CG and the MG students practical skills during two years of training, forming 6 groups accordingly, using the self-assessment coefficient (SAC) of the trainee, developed by us on the questionnaires and the practical skills coefficient (PSC) based on the evaluation sheets was determined, summarized and generalized for each group. The Lykert 6-point scale (0-5) of competence levels total assessments were used

Myomectomy during the cesarean section

Согласно поставленной цели обосновать преимущества разработанного способа консервативной миомэктомии во время кесарева сечения было обследовано 122 беременные женщины с миомой матки: 1 группа – 55 женщин, которым проведено только кесарево сечение; 2 группа – 67 женщин, которым во время кесарева сечения выполнена миомэктомия по разработанному способу; группа контроля – 30 женщин без соматических и гинекологических заболеваний, родоразрешенных путем кесарева сечения. В результате исследования установлено, что миомэктомия не увеличивает продолжительность оперативного вмешательства и объем кровопотери; послеоперационный период имеет неосложненное течение; продолжительность пребывания в стационаре не увеличивается.According to the goal get in order, to prove the advantages of the developed myomectomy method during cesarean section 122 pregnant women with uterine myoma were investigated: 1st group – 55 women who executed only a cesarean section, 2nd group – 67 women who at the time of cesarean section were performed myomectomy under the developed method and the control group – 30 women without somatic and gynecological diseases with a cesarean delivery. The study resulted in that myomectomy did not increase the duration of surgery and the amount of blood loss. The postoperative period was uncomplicated and their hospital stay was not longed

Estimation of hormone-receptor status and proliferative activity of endometrial hyperplasia

В результате проведения иммуногистохимического исследования маркера пролиферации Кі-67 и ER, PR в образцах эндометриальной ткани 60 женщин с гиперпластическими процессами и аденокарциномой и 15 пациенток с двухфазным менструальным циклом было выявлено, что экспрессия протеина Кі-67 увеличивалась по мере прогрессирования степени пролиферативного процесса. Рецепторный аппарат эндометрия характеризовался преобладанием PR над ER при простой и комплексной гиперплазии, а при атипических формах установлено преобладание ER над PR, что в условиях эстрогенного влияния может способствовать неконтролируемому пролиферативному действию. Проявление изучаемых процессов было более выражено в эпителиальных клетках эндометрия, чем в стромальных, и характеризовалось выраженной очаговостью.Studying development and expression proliferation marker Кі-67, ER, PR in epithelial and stromal endometrium at hyperplasia processes and their prognostic significance determination. An immunohistochemical investigation of endometrium was done in 74 women. The main group consisted of 60 women with hyperplasia of endometrium and adenocarcinoma (11 — simple hyperplasia without atypia, 18 — complex hyperplasia without atypia, 10 — simple hyperplasia with atypia, 13 — complex hyperplasia with atypia, 8 — adenocarcinoma), the control group consisted of 15 patients with morphological unchanged endometrium (proliferation stage n=6, secretion stage n=9). We defined proliferation markers Кі67 and ER, PR in epithelial and stromal endometrium by using immunohistochemical methods.Increasing expression of the protein Кі-67 by the progression of stage of the proliferative process was identified as a result of immunohistochemical research. The receptor apparatus of endometrium was characterized by a predominance PR over ER by the simple and complex hyperplasia and predominance ER over PR by the atypical form Conclusions. Estrogens, in case of their own receptor predominance over progesterone receptors, have uncontrolled proliferative influence which is accompanied by elevated levels of expression of the proliferation marker Кі-67

Incidence of multiple myeloma among cleanup workers of the chornobyl accident and their survival

The study presents the updated data on the multiple myeloma (MM) incidence in Ukrainian cleanup workers after the Chornobyl accident and their survival. The epidemiological analysis is based on the extended follow-up period to identify new MM cases for higher statistical power and to collect additional data on the disease course and outcome for the survival analysis. The objective of the study was to analyze the MM incidence and survival in Chornobyl cleanup workers in 1996–2013 in comparison with the national MM statistical data. Materials and Methods: A study cohort consisted of 152,520 male cleanup workers resided in one of 6 regions of Ukraine or Kyiv city and registered in the Ukrainian State Chornobyl Registry (SChR). The Cohort Database was linked to the Ukrainian National Cancer Registry (NCR) Database to identify MM cases and to analyze MM incidence in 1996– 2013. Standardized incidence ratios (SIR) for MM over the period 1996–2013 were calculated as compared to the general population of Ukraine. A 10-year lag period (when incident cases are not considered radiation-related) was applied. One-year and 5-year cause-specific survival of MM cases were calculated as percentage of those who were alive correspondingly for 1 or 5 years after diagnosis among overall diagnosed. By the moment, the 5-year survival rate either for the sub-period 2008–2013 or for the whole study period 1996–2013 cannot be determined. Vital status data were updated according to the recent SChR and NCR information. Results: 75 MM cases diagnosed in 1986–2013 were identified in the studied cohort. 69 of them were included to the incidence analysis considering a 10-year lag period. While the incidence over 15 years after the accident did not differ significantly from the corresponding rate in general population of Ukraine, a tendency to increase was seen in the period from 16 to 21 years after the accident, and significantly increased SIR estimate was revealed for 2008–2013 (SIR 1.86, 95% confidence interval (CI) 1.27–2.44). The highest incidence was detected in 2008–2013 among cohort members diagnosed over the age of 50 years mostly due to the significant excess among those aged 60–69 (SIR 2.46, 95% CI 1.32–3.59). Survival rates in cleanup workers were shown to be higher than in the general population of Ukraine (73.9% and up to 65.0%, respectively). Conclusions: SIR for the 2008– 2013 period, 22–27 years after the accident, demonstrated the significant excess of MM incidence among male cleanup workers. Survival of MM cases is higher in cleanup workers in comparison with that in general population. This article is a part of a Special Issue entitled “The Chornobyl Nuclear Accident: Thirty Years After”

Role of calcitriol in modulating of placental dysfunction in pregnant women with chronic kidney disease

Плейотропные эффекты витамина D (VD), активная форма которого синтезируется в почках, играют определенную роль в формировании и функционировании фетоплацентарной системы, в том числе при различных осложнениях беременности. Цель работы ‒ оценка уровня витамина D у беременных с плацентарной дисфункцией (ПД) и хроническими воспалительными заболеваниями почек (ХВЗП). В течение 24‒34 недель беременности обследовано 56 женщин с ПД (группа I ‒ основная), 24 (42,85 %) из которых страдали хроническим пиелонефритом (группа IA). Контрольную группу (группа II) составила 31 условно здоровая беременная женщина. Уровень общего VD в крови определяли методом ИФА; в дополнение к общему стандартному клиническому исследованию было выполнено также бактериологическое исследование мочи. Установлено, что средний уровень VD у беременных с ПД и хронической болезнью почек был значительно ниже, чем в контрольной группе (31,08 ± 7,2 и 45,42 ± 9,67 нг/мл (р < 0,01)). Оптимум VD выявлен только у 33,33 % беременных женщин в группе IA, в контрольной группе – у 93,55 % (р < 0,01), у 17,86 % обследованных в группе I и у 8,33 % беременных в группе IA был дефицит VD (ОR = 2,09; ДИ 95 % ‒ 1,8‒2,42). Женщин с VD-дефицитным статусом в контрольной группе не было. У 58,33 % женщин в группе ІА был субоптимальный уровень VD, в контрольной группе ‒ у 6,45 % (ОR = 3,57; ДИ 95 % ‒ 1,62‒7,88). Бактериурия диагностирована у всех беременных с VD-дефицитным или субоптимальным уровнем. При оптимальном уровне VD бактериурия определялась в 2 раза реже (χ2 = 66,67; р < 0,01). У пациентов с неадекватным уровнем VD ХВЗП диагностировали в 3,8 раза чаще (ОR = 3,57; ДИ 95 % ‒ 1,62‒7,88). Значительное снижение уровня кальцитриола у беременных с дисфункцией плаценты позволяет предположить, что дефицит или недостаточный уровень VD и воспалительные заболевания почек являются взаимозависимыми процессами, которые играют важную роль в формировании плацентарной дисфункции.The pleiotropic effects of vitamin D (VD), whose active form is synthesized in the kidneys, play a certain role both in forming and functioning the feto-placental system, including various pregnancy complications. The aim of the study was to evaluate the vitamin D status in pregnant women with placental dysfunction (PD) and chronic inflammatory kidney disease (CIKD). During 24–34 pregnancy weeks, 56 pregnant women with PD were examined (main group ‒ I); 24 patients (42.85 %) had chronic pyelonephritis (group IA). The control group (group II) had 31 conditionally healthy pregnant women. The total VD level in the blood was determined by ELISA; in addition to the general clinical standard examination, the urine also underwent bacteriological examination. The VD mean level in pregnant women with PD and CIKD was significantly lower than that in the control group (31.08 ± 7.2 and 45.42 ± 9.67 ng/ml (p < 0.01)). Only 33.33 % of pregnant women in group IA had a VD optimum, as well as 93.55 % (p < 0.01) in the control group and 17.86 % in group I. 8.33 % of pregnant women had a VD deficiency in group IA (RR = 2.09; CI 95 % ‒ 1.8‒2.42). The patients with a VD-deficiency were absent in the control group. 58.33 % of women in group ІА had a suboptimal VD level and 6.45% in the control group (RR = 3.57; CI 95 % ‒ 1.62‒7.88). Bacteriuria was observed in all pregnant women with a VD-deficient or suboptimal level. At the optimum VD level, bacteriuria was diagnosed twice less (χ2 = 66.67; p < 0.01). In patients with an inadequate VD level, CIKD was diagnosed 3.8 times more (RR = 3.57; CI 95 % ‒ 1.62‒7.88). The pleiotropic effects of vitamin D (VD), whose active form is synthesized in the kidneys, play a certain role both in forming and functioning the feto-placental system, including various pregnancy complications. The aim of the study was to evaluate the vitamin D status in pregnant women with placental dysfunction (PD) and chronic inflammatory kidney disease (CIKD). During 24–34 pregnancy weeks, 56 pregnant women with PD were examined (main group ‒ I); 24 patients (42.85 %) had chronic pyelonephritis (group IA). The control group (group II) had 31 conditionally healthy pregnant women. The total VD level in the blood was determined by ELISA; in addition to the general clinical standard examination, the urine also underwent bacteriological examination. The VD mean level in pregnant women with PD and CIKD was significantly lower than that in the control group (31.08 ± 7.2 and 45.42 ± 9.67 ng/ml (p < 0.01)). Only 33.33 % of pregnant women in group IA had a VD optimum, as well as 93.55 % (p < 0.01) in the control group and 17.86 % in group I. 8.33 % of pregnant women had a VD deficiency in group IA (RR = 2.09; CI 95 % ‒ 1.8‒2.42). The patients with a VD-deficiency were absent in the control group. 58.33 % of women in group ІА had a suboptimal VD level and 6.45% in the control group (RR = 3.57; CI 95 % ‒ 1.62‒7.88). Bacteriuria was observed in all pregnant women with a VD-deficient or suboptimal level. At the optimum VD level, bacteriuria was diagnosed twice less (χ2 = 66.67; p < 0.01). In patients with an inadequate VD level, CIKD was diagnosed 3.8 times more (RR = 3.57; CI 95 % ‒ 1.62‒7.88). The pleiotropic effects of vitamin D (VD), whose active form is synthesized in the kidneys, play a certain role both in forming and functioning the feto-placental system, including various pregnancy complications. The aim of the study was to evaluate the vitamin D status in pregnant women with placental dysfunction (PD) and chronic inflammatory kidney disease (CIKD). During 24–34 pregnancy weeks, 56 pregnant women with PD were examined (main group ‒ I); 24 patients (42.85 %) had chronic pyelonephritis (group IA). The control group (group II) had 31 conditionally healthy pregnant women. The total VD level in the blood was determined by ELISA; in addition to the general clinical standard examination, the urine also underwent bacteriological examination. The VD mean level in pregnant women with PD and CIKD was significantly lower than that in the control group (31.08 ± 7.2 and 45.42 ± 9.67 ng/ml (p < 0.01)). Only 33.33 % of pregnant women in group IA had a VD optimum, as well as 93.55 % (p < 0.01) in the control group and 17.86 % in group I. 8.33 % of pregnant women had a VD deficiency in group IA (RR = 2.09; CI 95 % ‒ 1.8‒2.42). The patients with a VD-deficiency were absent in the control group. 58.33 % of women in group ІА had a suboptimal VD level and 6.45% in the control group (RR = 3.57; CI 95 % ‒ 1.62‒7.88). Bacteriuria was observed in all pregnant women with a VD-deficient or suboptimal level. At the optimum VD level, bacteriuria was diagnosed twice less (χ2 = 66.67; p < 0.01). In patients with an inadequate VD level, CIKD was diagnosed 3.8 times more (RR = 3.57; CI 95 % ‒ 1.62‒7.88). The pleiotropic effects of vitamin D (VD), whose active form is synthesized in the kidneys, play a certain role both in forming and functioning the feto-placental system, including various pregnancy complications. The aim of the study was to evaluate the vitamin D status in pregnant women with placental dysfunction (PD) and chronic inflammatory kidney disease (CIKD). During 24–34 pregnancy weeks, 56 pregnant women with PD were examined (main group ‒ I); 24 patients (42.85 %) had chronic pyelonephritis (group IA). The control group (group II) had 31 conditionally healthy pregnant women. The total VD level in the blood was determined by ELISA; in addition to the general clinical standard examination, the urine also underwent bacteriological examination. The VD mean level in pregnant women with PD and CIKD was significantly lower than that in the control group (31.08 ± 7.2 and 45.42 ± 9.67 ng/ml (p < 0.01)). Only 33.33 % of pregnant women in group IA had a VD optimum, as well as 93.55 % (p < 0.01) in the control group and 17.86 % in group I. 8.33 % of pregnant women had a VD deficiency in group IA (RR = 2.09; CI 95 % ‒ 1.8‒2.42). The patients with a VD-deficiency were absent in the control group. 58.33 % of women in group ІА had a suboptimal VD level and 6.45% in the control group (RR = 3.57; CI 95 % ‒ 1.62‒7.88). Bacteriuria was observed in all pregnant women with a VD-deficient or suboptimal level. At the optimum VD level, bacteriuria was diagnosed twice less (χ2 = 66.67; p < 0.01). In patients with an inadequate VD level, CIKD was diagnosed 3.8 times more (RR = 3.57; CI 95 % ‒ 1.62‒7.88). A significantly calcitriol reduction in pregnant women with placental dysfunction suggests that the deficiency or the suboptimal level of vitamin D and inflammatory kidney diseases may be the interdependent processes that play a decisive role in the formation of placental dysfunction