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

Abstract

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.

Role of Salivary Uric Acid Versus Serum Uric Acid in Predicting Maternal Complications of Pre-Eclampsia in a Rural Hospital in Central India: A Two-Year, Cross-Sectional Study

“…The results concluded that serum uric acid can predict the mode of delivery (normal vaginal or cesarean) among cases of severe pre-eclampsia. These results were corroborated by another study by Kumar et al (2019) [ 36 ], where a significant difference was observed among cases who underwent normal vaginal delivery and cesarean section. In the study by Padma et al (2015) [ 37 ], high serum uric acid levels were associated with delivery by cesarean section.…”

Association of serum uric acid and serum lipid profile in pre- eclampsia- A hospital based case-control study

“…Pre-eclampsia accounts for 10-15% of all the maternal deaths occurring worldwide. The most common reason for such high maternal and fetal morbidity and mortality is the unavailability of precise and specific test that can iden fy 12 pregnant women at risk of developing pre-eclampsia.…”

Correlation of Maternal Serum Uric Acid Level and Feto-maternal Outcome in Hypertensive Disorder of Pregnancy: A Prospective Study

“…Studies have also shown that with the increase in maternal uric acid level, fetal and maternal complications also increases. [7,8] Several studies have shown that with the increase in maternal serum uric acid level, there is an increased risk of fetal complications. In this study, there were 8 cases of IUGR, 4 cases of IUFD and 4 cases of prematurity in women with serum uric acid levels< 5.5mg/dl, whereas there were 7 IUGR, 4 IUFD and 10 prematurity cases in women with serum uric acid level ≥ 5.5mg/dl.…”

“…Since then, several studies have been done to correlate its severity with the feto-maternal outcome. [7,8,9] Rajalaxmi et al have reported a threshold value of the uric acid level of 5.5mg/dl in women with preeclampsia with the adverse feto-maternal outcome. Around 68% of women with serum uric acid more than 5.5mg/dl were associated with preterm delivery and birth weight less than 2.5kg.…”