Serum uric acid levels as a risk stratification tool in hypertensive pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20184689Keywords:
Coagulopathy, Pre-eclampsia, Protienuria, Uric acidAbstract
Background: Hypertensive disorders represent the most common medical complication of pregnancy affecting between 7-15% of all gestations and accounts for approximately a quarter of antenatal admissions.
Methods: A case-control study was conducted over a period of 1 year. A total of 200 subjects were enrolled in the study and were divided into two groups; 100 cases and 100 controls. Serum uric acid levels were measured in cases and controls. The serum uric acid levels were correlated with the severity of PIH and maternal and fetal complications.
Results: It was observed that the mean serum uric acid level in cases (5.0±1.74 mg/dl) was significantly higher compared to 2.66±0.39 mg/dl in controls. Serum uric acid levels also tended to increase with increasing severity of PIH, increasing from 3.69±0.95 mg/dl in gestational hypertension to 6.36±1.38mg/dl in severe PE. Maternal complications during antepartum and postpartum period were higher once SUA≥5mg/dl was taken as a cut-off. Protienuria(p=0.00), coagulopathy(p=0.007), need for blood/platelet transfusion(p=0.01) and eclampsia (p= 0.007) were significantly more. Similarly, complications were found to be higher, in babies born to mothers having serum uric acid more than 5 mg/dl compared to others in case group.
Conclusions: Higher serum uric acid levels may indicate higher risk of progression to preeclampsia and development of adverse maternal/infant conditions.
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References
James PR, Nelson- Piercy. Mnagement of Hypertension before, during, and after pregnancy. Heart. 2004;90(12):1499-1504.
Slemons JM, Bogert LJ. The uric acid content of maternal and fetal blood. J Biol Chem. 1917;32(1):63-9.
Stander HJ, Cadden JF. Blood chemistry in preeclampsia and eclampsia. Am J Obstet Gynaecol. 1934;28(6):856-71.
Voto LS, Illia R, Darbon-Grosso HA, Imaz FU, Margulies M. Uric acid levels: a useful index of the severity of preeclamsia and perinatal prognosis. J Perinat Med. 1988;16(2):123-26.
Roberts JM, Bodnar LM, Lain KY, Hubel CA, Markovic N, Ness RB, et al. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertens. 2005;46(6):1263-69.
Bainbridge SA, Roberts JM. Uric acid as a pathogenic factor in preeclampsia. Placenta. 2008;29:67-72.
Katharia CL, Lafayette RA. Renal physiology of pregnancy.” Advances in Chronic Kidney Dis. 2013;20(3):209-14.
Pennington KA, Schlitt JM, Jackson DL, Schulz LC, Schust DJ. Preeclampsia: multiple approaches for a multifactorial disease. Disease Model Mechanism. 2012;5(1):9-18.
Jeyabalan A, Conrad KP. Renal function during normal pregnancy and preeclampsia. Front Biosci. 2007;12(1)2425-37.
Dekker GA, Sibai BM. Early detection of pre-eclampsia. Am J Obstet Gynecol, Vol. 165, No. 1, 1991;165(1):160-72.
Dekker GA, Sibai BM. Low- dose aspirin in the prevention of preeclampsia and fetal growth retardation: rationale, mechanism, and clinical trials. Am J Obstet Gynecol. 1993;168(1):214-27.
Sarmah J. A Comparative Study of Serum Uric Acid in Gestational Hypertension, Preeclampsia and Normal Pregnancy. IOSR (IOSR-JDMS). 2015;14(8):4-6.
Kamath KR, Nayak SR, Shantharam M. Serum uric acid level in preeclampsia and its correlation to maternal and foetal outcome. Int J Biomed Res. 2014;5(01):22-4.
Pereira KN, Knoppka CK, Da Silva JE. Association between uric acid and severity of pre-eclampsia. Clinical Lab. 2013;60(2):309-14.
Nischintha S, Pallavee P, Ghose S. Correlation between 24-h urinary protein , spot urine protein/creatinine ratio, and serum uric acid and their association with fetomaternal outcomes in preeclamptic women. J Nat Sci Biol Med. 2014;5(2): 255-60.
Tejal P, Astha D. Relationship of serum uric acid level to maternal and perinatal outcome in patients with hypertensive disorders of pregnancy. Gujarat Medical J. 2014;69(2):1-3.
Priya AR, Jeyapriya K, Kannan NS. Accuracy of serum uric acid in predicting complications of preeclampsia . Int J Cur Res Rev. 2016;8(5):13-21.