Plasma-Urate Measurements in Predicting Fetal Death in Hypertensive Pregnancy

Redman, C. W. G.; Beilin, L. J.; Bonnar, J.; Wilkinson, Robert H.

doi:10.1016/s0140-6736(76)93024-5

Cited by 251 publications

(99 citation statements)

References 12 publications

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“…REDMAN et al [5], FADEL et al [3] and VARMA [10] reported that SUA levels for PE patients were markedly elevated as compared with EH women, whose uricemia was in turn higher than in normal pregnant women.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Uric acid levels: a useful index of the severity of preeclampsia and perinatal prognosis

Voto¹,

Illia²,

Darbon-Grosso³

et al. 1988

Journal of Perinatal Medicine

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Section: Discussionmentioning

confidence: 99%

“…Several authors [1,3,4,5,6,7,10] have stated that hyperuricemia associated with a hypertensive pregnancy increases the incidence of intrauterine growth retardation, low birth weight and severe fetal distress.…”

Section: Discussionmentioning

confidence: 99%

Uric acid levels: a useful index of the severity of preeclampsia and perinatal prognosis

Voto¹,

Illia²,

Darbon-Grosso³

et al. 1988

Journal of Perinatal Medicine

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“…Subsequent studies confirmed these findings. [8][9][10][11][12][13][14][15][16][17] Wakwe and Abudu showed elevated uric acid to be associated with eclampsia 12 while Roberts et al 14 showed that the risk of preterm birth, and small-for-gestational-age infants increased with increasing uric acid. The severity of retinopathy in preeclamptic patients has also been found to be directly related to serum uric acid level.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have suggested that it is suboptimal as a predictor of preeclampsia; [4][5][6] however, uric acid does appear to correlate with adverse maternal and neonatal outcomes. [7][8][9][10][11][12][13][14][15][16][17] Current management of the patient with mild preeclampsia who is preterm (that is, <37 weeks gestation) often includes hospital admission, the administration of steroids to promote fetal lung maturity (if <34 weeks), and ongoing maternal and fetal surveillance. Patients with severe preeclampsia are typically delivered by 34 weeks.…”

Section: Introductionmentioning

confidence: 99%

Admission uric acid levels and length of expectant management in preterm preeclampsia

et al. 2011

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Objective: Uric acid is known to be elevated in preeclampsia. We sought to determine if uric acid levels on admission correlate with the length of expectant management in preterm patients with preeclampsia.Study Design: A retrospective chart review was conducted on singleton preeclamptic pregnancies delivered between 24 0/7 and 37 0/7 weeks' gestation at Tufts Medical Center between January 2005 and December 2007. Patients with a multiple gestation and those transferred or discharged before delivery were excluded. Data regarding signs and symptoms of preeclampsia, laboratory values, pregnancy complications and outcome were abstracted from the medical records. Correlation between admission uric acid level and days of expectant management was assessed. The relative risk (RR) was used to estimate the effect of uric acid levels on expectant management length >7 days. Mantel-Haenszel w 2 values were used to construct 95% confidence intervals (CIs) around the RR.Result: Four hundred seventy-one charts were reviewed. Of these, 190 met inclusion criteria. In all, 55 patients (28.9%) were managed expectantly for >1 week. Admission uric acid level correlated with days of expectant management (P<0.0001). Uric acid levels at admission were categorized as p4.0 mg dl -1 (low uric acid level), 4.1 to 6.0 mg dl -1 (medium) and X6.1 mg dl -1 (high). Relative to women with high uric acid levels at admission, we observed a sevenfold higher rate of extending expectant management for >1 week among women with low uric acid level (7.0; 95% CI: 3.34 to 14.68). Women with medium uric acid levels at admission also had a higher likelihood of prolonging pregnancy relative to women with high uric acid levels (RR: 2.81; 95% CI: 1.32 to 5.96) (P-value for trend <0.0001).Conclusion: Admission uric acid levels correlate with the length of expectant management in preterm patients with preeclampsia. Pregnancy prolongation for >1 week is significantly more likely in patients with low and medium uric acid levels at the time of admission. Uric acid levels may be helpful in assessing disease severity and counseling preeclamptic patients regarding likelihood of extended expectant management.

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“…15 mostraron que los niveles altos de ácido úrico podrían predecir eventos fetales adversos en mujeres con hipertensión del embarazo. Posterior a ello, varios estudios resumidos en revisiones recientes 5,[16][17][18] , confirman un elevado riesgo (~2 veces) de presentar resultados perinatales adversos, tanto en la madre como en el recién nacido en mujeres hipertensas con hiperuricemia.…”

Section: áCido úRico Y Pre-eclampsiaunclassified

Purinas y ácido úrico en pre-eclampsia: interacciones fisiopatológicas y proyecciones en investigación

et al. 2013

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Uric acid and purine plasma levels as plausible markers for placental dysfunction in pre-eclampsia E l ácido úrico, producto final del metabolismo de las purinas, es utilizado como marcador de daño renal y factor de riesgo de morbilidad materna y neonatal en embarazos con pre-eclampsia 1-3 . Así, las mujeres hipertensas e hiperuricémicas tienen mayor riesgo de parto pretermino, retardo de crecimiento intrauterino (RCIU) y pre-eclampsia de origen temprano (< 34 semanas), que aquellas mujeres con embarazos normales o mujeres pre-eclámpticas sin hiperuricemia 3,4 . Conjuntamente, una serie de estudios 5-7 sugieren que los embarazos con preeclampsia cursan con altos niveles de purinas (i.e., ATP, ADP, AMP, adenosina). Las causas o efectos de este aumento en el metabolismo de las purinas hasta ácido úrico no se conocen; sin embargo, dado que pre-eclampsia (principalmente de origen temprano) se asocia a un aumento en la liberación de restos celulares hacia la circulación materna, es posible que estos constituyan el principal sustrato para el metabolismo de las purinas, y finalmente formación de ácido úrico 8 . Por ello, el aumento de ácido úrico y purinas en embarazos con pre-eclampsia no sólo obedecería a la alteración de la función renal, sino que sería un marcador de disfunción placentaria. El objetivo de este trabajo es contribuir en el análisis del rol de las purinas y el ácido úrico en la fisiopatología de pre-eclampsia y con ello replantear su potencial rol predictivo en pre-eclampsia y enfermedades cardiovasculares. Es necesario indicar que este es un análisis de la literatura disponible en el cual nos permitimos especular sobre estas posibles conexiones.

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Plasma-Urate Measurements in Predicting Fetal Death in Hypertensive Pregnancy

Cited by 251 publications

References 12 publications

Uric acid levels: a useful index of the severity of preeclampsia and perinatal prognosis

Uric acid levels: a useful index of the severity of preeclampsia and perinatal prognosis

Admission uric acid levels and length of expectant management in preterm preeclampsia

Purinas y ácido úrico en pre-eclampsia: interacciones fisiopatológicas y proyecciones en investigación

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