Abstract
Aim: To evaluate the biochemical parameters in determining the severity of pre-eclampsia andcompare the efficacy between protein creatinine ratio and calcium creatinine ratio in determiningorgan dysfunction in ante-natal women with pregnancy-induced hypertension. Material andMethods: 150 cases of pregnancy-induced hypertension admitted in the labour room were studiedin the Department of Obstetrics and Gynaecology, SRMSIMS and were divided into two groups mildand severe pre-eclampsia depending on blood pressure, clinical and biochemical parameters. Variousparameters for renal function and liver function were evaluated along with fundoscopy. Results: Onthe evaluation of various parameters of renal function test and liver function test, a statisticallysignificant p-value was observed with increase in grade of pre-eclampsia. When abnormal organfunctions were compared, it was observed that PCR ≥ 0.3 is associated with 85%, 75.6% and81.25% cases of abnormal fundoscopy, deranged renal function test and deranged liver function testcompared to CCR ≤ 0.04 which was associated with 77%, 78.6% and 65% cases of abnormalfundoscopy, deranged renal function test and deranged liver function test respectively. Conclusion:The degree of derangement among biochemical parameters increases as the disease progresses.Early determination by a single test helps to predict organ involvement and correlates with diseaseseverity.
Highlights
Hypertensive disorder of pregnancy accounts for the third most common cause of maternal mortality after haemorrhage and sepsis
This study shows that a high absolute magnitude of liver and renal function test as well as fundoscopic findings are useful means to predict disease severity
If a single biochemical test is required our finding for both protein creatinine ratio and calcium creatinine ratio in assessing disease severity is approx 50 % sensitive
Summary
Hypertensive disorder of pregnancy accounts for the third most common cause of maternal mortality after haemorrhage and sepsis. Pre-eclampsia is a multisystem disorder associated with a rise in blood pressure after the 20th week of gestation. Spot urinary protein-creatinine ratio is one of the variables shown to be sufficient to assess proteinuria in the diagnosis of pre-eclampsia compared to the 24-hour value and a ratio > 0.3 mg/dl has been shown to meet or exceed 300 mg protein in 24-hour urinary collection [3]. Another parameter is decreased in urinary calcium-creatinine ratio. We tried to find out a better biochemical predictor which can detect the pathological changes of pre-eclampsia more reliably
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