An association of renal profile with maternal complications in women with preeclampsia

Abstract

Background: Preeclampsia is a multisystem disorder characterized by the development of hypertension to the extent of 140/90 mmHg or more with proteinuria after the 20th week in a previously normotensive and nonproteinuric woman. Renal parameters(Blood urea, Serum creatinine, Uric acid, Urinary protein by dipstick) in patients with preeclampsia. if raised above the normal pregnant values, can help establish the severity of preeclampsia and its associated complications and can help in predicting maternal and perinatal outcomes. The aim of the article was to assess the renal profile in preeclampsia and its association with maternal complications. Materials and Methods: This prospective observational study was conducted in a tertiary health center over two years, from October 2020 to October 2022. Informed written consent had been obtained from women as per the inclusion criteria. With pre-determined proforma, detailed history was obtained. All pregnant women who fulfilled the inclusion criteria after 20 weeks of gestation were included in the study. Apart from routine antenatal investigations in pregnancy, Renal Function Tests (RFTs) were also done in women with preeclampsia. The renal parameters used in the study were Blood urea, Serum creatinine, Serum uric acid, and Urinary protein. The patients with raised renal parameters were followed up repeatedly till delivery. The RFTs were repeated if needed. The maternal outcomes were noted. Results: In the present study, out of 167 women, 67% of preeclampsia patients had no complications, 22% had developed impending eclampsia, 6% had developed hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, and only 3% of the patients had gone into eclampsia. Serum uric acid levels were more than 6.3 in 76% of patients with impending eclampsia, 50% of patients with eclampsia, and 36% of patients with HELLP syndrome.Almost 90% of the patients with HELLPsyndrome had severe proteinuria of urinary protein as 3+, while 73% of impending eclampsia patients had urinary protein 3+. Conclusion: Due to severe impact of preeclampsia on pregnancy outcomes, prompt, and early identification of preeclampsia by using these renal function tests and timely initiation of treatment is essential.