Comparative Study of Serum Calcium and Magnesium in Pre-eclamptic Pregnancies in Third Trimester and its Comparison with Healthy Normotensive Nonpregnant and Pregnant Women and to Evaluate their role in Pregnancy-induced Hypertension

Abstract

Background: Despite numerous studies, the etiology of pre eclampsia has not been fully elucidated. The study of serum calcium and serum magnesium is gaining ground in the patho physiology of hypertension.Objective: A comparative study of serum calcium and serum magnesium in women with preeclamptic pregnancy and its comparison with healthy normotensive nonpregnant women and healthy normotensive pregnant women in third trimester. Materials and methods:Serum calcium and serum magnesium were measured in 52 women with preeclampsia in their trimester of pregnancy as patients group, and in 73 healthy normotensive nonpregnant women and 65 healthy normotensive pregnant women as control groups with similar maternal and gestational ages. Preeclamptic group was further divided into two subgroups mild (n = 36) and severe preeclampsia (n = 16). This is the casecontrol hospital based study carried in the Department of Biochemistry, MGM Medical College and associated MY Hospital, Indore, Madhya Pradesh.Results: There were no significant differences among the three groups in age and body mass index (BMI) (p > 0.05) but significantly higher differences in gestational age, systolic and diastolic blood pressure was observed (p < 0.001). When com parison of serum calcium and serum magnesium between healthy normotensive nonpregnant women (9.87 ± 0.6 mg/dl, 2.60 ± 0.3 mg/dl) and healthy normotensive pregnant women was done, the levels were lower in the healthy normotensive preg nant women (9.34 ± 0.49 mg/dl, 2.36 ± 0.13 mg/dl) with sta tistically higher significant difference (p < 0.001). Lower mean values of serum calcium and serum magnesium were found in preeclamptic women (8.82 ± 0.93 mg/dl, 1.74 ± 0.24 mg/dl) than those of healthy normotensive nonpregnant women (9.87 ± 0.6 mg/dl, 2.60 ± 0.3 mg/dl) and healthy normotensive pregnant women (9.34 ± 0.49 mg/dl, 2.36 ± 0.13 mg/dl) in third trimester with statistically higher significant differences (p < 0.001). As compare to mild preeclamptic pregnant women (9.07 ± 0.8 mg/ dl, 1.77 ± 0.24 mg/dl), the levels of serum calcium and serum magnesium in severe preeclamptic pregnant women (8.25 ± 0.97 mg/dl 1.65 ± 0.24 mg/dl) was lower and the difference was significantly higher (p < 0.001). Conclusion:These findings support the hypothesis that hypo calcemia and hypomagnesemia are possible etiologies of preeclampsia and levels of calcium may be more important than magnesium.

Assessment of the level of serum uric acid in patients of pre-eclampsia and their comparison with levels in normotensive pregnancy

“…Uric acid has multiple origins in cases of preeclampia like abnormal renal function due to renin activity and vasoconstriction, increased issue breakdown, acidosis and increased activity of xanthine oxidase dehydrogenase. 17 Even though the levels of uric acid cannot determine the extent of complications of preeclampsia and whatever be the origin of uric acid, raised levels of uric acid are a significant finding in cases of pre-eclampsia by itself. In this case control study, the mean of levels of uric acid in the study group was 6.13 which was higher than the mean of the same in the control group 5.11, which is consistent with the finding that hyperuricemia is more commonly seen in preeclampsia patients.…”

Comparative analysis of serum calcium and magnesium as a better predictor in cases of mild and severe pre-eclampsia.

“…Some studies agreed with role of both elements but some put emphasis on the role of magnesium and other give importance to calcium. 9,10,11 Alteration in metabolism of calcium and magnesium during pregnancy is considered to be one of etiological factor for preelampsia and it is proposed that in developing countries like Pakistan, females in their reproductive years particularly in pregnancy are prone to micro and macro nutrient insufficiency due to increase demand of growing fetus and poor body reserves.…”