الفهرس 
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Abstract
The definition of RPL has long been debated and differs among
international societies. The European Society for Human
Reproduction and Embryology (ESHRE) suggested inclusion of two
or more pregnancy losses including non-consecutive pregnancy losses
while the other guidelines focus on including only consecutive
pregnancy losses (El Hachem et al., 2017).
RPL affects approximately 1 to 2% of women taking into
consideration three consecutive pregnancy losses occurring before 20
weeks of gestation (Sultana et al., 2020). Factors generally accepted
to be associated with RPL include uterine anomalies, maternal
antiphospholipid syndrome (APS), maternal thrombophilia, endocrine
disease, autoimmune diseases and parental structural chromosomal
abnormalities (Youssef et al., 2020). Standard investigations will be
normal for many couples and the cause of RPL is deemed
(Ng et al., 2021).
Vitamin D is a crucial modulator of essential biological effects,
such as immune function and hormone secretion via the vitamin D
receptors. Vitamin D affects the innate and acquired immune response
(Mora et al., 2008), as well as exerts an inhibitory function on the
adaptive immune system (Ota et al., 2015).
Vitamin D deficiency during pregnancy is a common problem
worldwide. Vitamin D deficiency in pregnant women is associated
with increased risk of obstetrical complications, such as preeclampsia,
bacterial vaginosis and the associated preterm delivery, gestational
diabetes mellitus, and small-for-gestational age births (Ghaedi et al.,
2016).
Summary
86
With these immune modulatory effects of vitamin D, it has been
speculated that vitamin D could act as an immune regulator during
implantation and play an important role in reproductive capacity. In
early pregnancy, trophoblasts produce and respond to vitamin D, and
some investigators have demonstrated that vitamin D influences local
anti-inflammatory responses and induces decidualization for
successful pregnancy (Ota et al., 2014).
This study was performed to evaluate the role of vitamin D
supplementation in prevention of unexplained recurrent pregnancy
loss in patients with vitamin D deficiency.
The study involved two groups of pregnant females in early
first trimester (6 weeks) with history of unexplained recurrent
pregnancy loss (two or more consecutive miscarriage before 20 weeks
of gestation) and had had low serum vitamin D <30 ng/ml. group I
included 50 pregnant females who received oral vitamin D3
supplementation cholecalciferol by dose 4000 IU daily in the form of
40 DROP daily (DROP =100 IU) of ViDROP (Manufactured by Medical
Union Pharmaceuticals AbuSultan, Ismailia, Egypt) ,
group II included 50 age matched pregnant females who
received only the daily requirements of vitamin D3 400 IU daily in the
form of 4 drops daily of Vidrop.
Pregnant females with a known risk factor for subsequent
were
excluded from the study.
Methodology:
Pregnant females of both groups were subjected to full history
taking, complete general and obstetric examination, ultrasonographic
assessment and routine laboratory investigations.
Summary
87
About 3 ml of venous blood were aseptically withdrawn from
all the studied subjects. Serum levels of 25 (OH)D were measured by
enzyme linked immunosorbent assay (ELISA) technique according to
the manufacturer’s instructions using commercial ELISA Kits .The
pregnant females in both groups were followed up and pregnancy
outcome was determined. Pregnancy was considered successful if
continued beyond 20th weeks gestation.
Results:
There was no statistically significant difference (P > 0.05)
between both groups regarding age, occupation, special habits, BMI,
number of miscarriage and number of living children, and parity.
There was no statistically significant difference between the two
groups regarding vitamin D level.
There was no association between serum vitamin D level and
number of patients continuing pregnancy in both groups.
There were no association between pregnancy outcome and
patient age, residence, BMI, and number of previous miscarriages.
However, there were association between pregnancy outcome and
parity of the patient, her occupation, and number of living children.