Effect of raised serum uric acid level on perinatal and maternal outcome in cases of pregnancy-induced hypertension

Ahmed, Qumrun Nassa; Dewan, Farhana

doi:10.3329/bsmmuj.v10i2.31910

Cited by 4 publications

(4 citation statements)

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“…Regarding the socio-demographic features observed in the present study, it was found that the mean age of presentation in Gestational hypertension, Pre-eclampsia, and Eclampsia groups were 26.51 ± 3.82 years, 27.14 ± 3.64 years and 24.73 ± 4.01 years respectively, with maximum cases of pre-eclampsia and eclampsia occurring in women of 20-25 years of age group. This is similar to the results of various other studies which have reported that the highest incidence of HDP was found in women of age group 21-25 years [24, 25]. In our study, we have also observed that the women with severe pre-eclampsia belonged to 22-35 years of age group and in eclampsia 19-32 years.…”

Section: Discussionsupporting

confidence: 92%

Maternal Serum Uric Acid as a Predictor of Severity of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

Kumar

Singh

2019

CHYR

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Objective: To assess the relationship between maternal serum uric acid and severity of Hypertensive disorders of pregnancy in a rural tertiary care centre. Materials and Methods: Present study was conducted in Obstetrics and Gynaecology department of rural tertiary care centre of Northern India over seven months (October 2016-May 2017) on 110 women admitted with a Hypertensive disorder of pregnancy (Gestational hypertension, Preeclampsia, Eclampsia) at ≥;34 weeks gestation. Maternal serum uric acid levels were compared in three groups in relation to disease severity, mode of delivery, maternal outcome. Results: Of total 110 women with a Hypertensive disorder of pregnancy; 35 (31.81%) had Gestational Hypertension, 49 (44.54%) preeclampsia and 26 (23.63%) had eclampsia. Mean±SD values for serum uric acid were 5.47±1.93 mg/dl in women with Gestational Hypertension; 6.72±2.15 mg/dl in Pre-eclampsia and 8.71±2.97 mg/dl in the eclamptic group. Of 110 women 34(97.14%) with gestational hypertension, 27(55.10%) with pre-eclampsia and one (3.85%) with eclampsia remained stable in post-partum period, 17 (34.69%) women with severe pre-eclampsia and 15 (57.69%) with eclampsia required intensive care in postpartum period and one (2.86%) women with gestational hypertension, five (10.20%) with pre-eclmapsia and ten (38.46%) with eclampsia required ventilator support and high dependency unit care. Of these 16 women with the severe disease, ten succumbed to death. Also, in women with serum uric acid,>6mg/dl, most common mode of delivery was a lower segment cesarean section (50.90%). Conclusion: Significant correlation was observed between maternal serum uric acid, disease severity and maternal outcome.

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Section: Discussionsupporting

confidence: 92%

Maternal Serum Uric Acid as a Predictor of Severity of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

Kumar

Singh

2019

CHYR

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“…In a cross-sectional study conducted in Nepal amongst 90 pregnant women between 24 to 36 weeks of gestation, mean serum uric acid levels were higher in the pregnancyinduced hypertension group compared to the control group; 5.46mg/dL (324.8µmol/L) versus 4.03mg/dL (239.7µmol/L) 17 . Ahmad et al 18 reported that amongst 100 pregnant women who developed pre-eclampsia and serum uric acid was taken at mean gestational age of 33.5 weeks, had mean uric acid levels of 7.01mg/dL (417µmol/L). A meta-analysis on the prognostic role of serum uric acid in pre-eclampsia 19 included 196 studies involving 39540 women, found that higher uric acid was estimated for severe pre-eclampsia, eclampsia, haemolysis, elevated liver enzymes, and low platelet syndrome.…”

Section: Discussionmentioning

confidence: 99%

Uric Acid: Friend or Foe?

Shuaib

Ismail²,

Manaf³

et al. 2022

imjm

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Introduction. Adverse Pregnancy outcomes (APO) continue to trouble physicians worldwide, and uric acid has become a marker of interest in its prediction. Despite this, the correlation of uric acid in the third trimester is rarely studied, and the reference value for normal uric acid levels in pregnancy has yet to be established. This study was done to evaluate the association of uric acid levels in the third trimester of pregnancy and the development of APO, specifically gestational hypertension (GH), pre-eclampsia (PE), gestational diabetes mellitus (GDM), small for gestational age (SGA) and to determine a cut-off value of serum uric acid levels for screening of the APO. Materials and methods. A retrospective observational study was conducted among 374 women who delivered at Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and developed the APO of interest and had serum uric acid levels taken during the third trimester of pregnancy. A cut off value of 309 µmol/L was used to assess the sensitivity and specificity in predicting the APO. Results. Associations are observed between 309 µmol/L and the development of GH (p<0.0005), PE (p<0.0005), GDM (p<0.0005), SGA (p=0.0264). Plotted ROC curves with cutoff point of 309 µmol/L demonstrated moderate predictive value of serum uric acid and the development of GH (AUC 0.639), PE (AUC 0.713), SGA (AUC 0.649) and low predictive value for GDM (AUC 0.4). Conclusion. Serum uric acid level of 309 µmol/L in the third trimester of pregnancy is a moderate predictor of GH, PE, SGA and a poor predictor of GDM. KEYWORDS: Uric acid; pregnancy trimester, third; pregnancy outcome

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“…Serum uric acid level was negatively correlated to maternal serum AAT, in line with the earlier studies linking serum uric acid with intrauterine growth restriction, low Apgar score, and even fetal death. 14,15 One of the fetal adaptive mechanisms to hypoxia is increased kidney resistance, which decreases urine output and AFI, explaining the negative correlation with AAT. 14 Platelet indices showed a strong inverse correlation with AAT serum level in accordance with Nori et al, 16 who described that the consumed platelets will stimulate the bone marrow to produce new broader and larger platelets.…”

Section: Discussionmentioning

confidence: 99%

“…Oxidative stress initiates injury into endothelial cells and triggers a cascade of an inflammatory response (including AAT) that alters platelet indices and numbers. 15 Further, blood vessels and arterioles will suffer spasms, increasing the mean blood pressure and reduced blood supply to the vital organ. Reduced fetal nutrient decreases fetal weight and fetal weight percentile.…”

Section: Discussionmentioning

confidence: 99%

Maternal alpha‐1‐antitrypsin as a noval marker for growth restriction in pre‐eclampsia

Nori

Ali

2021

J of Obstet and Gynaecol

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Aim: To verify the role of maternal serum levels of alpha-1-antitrypsin (AAT), an acute-phase inflammatory protein, as a marker for distinguishing between fetal growth restriction (FGR) and normal birth weight in pre-eclamptic women. We correlate serum AAT levels to the essential feto-maternal parameters for an earlier and cost-benefit diagnostic method, thus distinguishing between FGR and normal birth weight in preeclamptic women. Methods: An observational study conducted at the University hospital recruited 100 pregnant women in 32/34 weeks of a singleton single tone pregnancy; all were pre-eclampsia cases. All were tested by laboratory and ultrasound examination. Two sets of data were collected; one is maternal parameters such as blood pressure (BP), maternal serum AAT mean platelet volume (MPV), platelet distribution width (PDW), and serum uric acid levels, and the other is fetal parameters such as amniotic fluid index (AFI), fetal weight centile and estimated fetal weight. Results: A strong negative correlation proved between serum levels of AAT and all study variables except fetal weight (systolic BP, diastolic BP, MPV, PDW, serum uric acid, fetal weight percentile, and AFI) with a correlation coefficient of; À0.95, À0.95, À0.85, À0.93, À0.91, À0.94, and À0.93 respectively. The cut-off value for AAT 0.013 mg/ml showed the highest sensitivity and specificity as a diagnostic marker for FGR. Area under the curve was 0.99. Conclusions: Negative correlations between maternal serum AAT and fetal parameters used to assess FGR were confirmed, suggesting that AAT is closely related to the pathophysiology of FGR among pre-eclamptic patients and may serve as a helpful tool in distinguishing between FGR and normal birth weight babies, pending further validation in feto-maternal outcomes.

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Effect of raised serum uric acid level on perinatal and maternal outcome in cases of pregnancy-induced hypertension

Cited by 4 publications

References 1 publication

Maternal Serum Uric Acid as a Predictor of Severity of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

Maternal Serum Uric Acid as a Predictor of Severity of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

Uric Acid: Friend or Foe?

Maternal alpha‐1‐antitrypsin as a noval marker for growth restriction in pre‐eclampsia

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