Comparison of maternal serum lipoproteins in normal pregnancyand primiparous patients with eclampsia

Rubina Nazli,Tasleem Akhtar,Hina Aslam,Akmal Khan,Jamila Haider,Nabila Sher

doi:10.12669/pjms.324.9859

Abstract

Objective:To evaluate changes in serum lipoproteins in primiparous women with eclampsia and compare it with pregnant women having normal blood pressure.Methods:This cross sectional study was conducted on 65 primiparous eclamptic patients and 21 normotensive pregnant women in the tertiary care hospitals of Peshawar. History of each woman was recorded on a questionnaire. Blood pressure was measured using standard methods. About 5 ml of venous blood was drawn for the analysis of lipoproteins. The data was analyzed using computer software package SPSS version 10. The P value <0.05 was considered statistically significant.Results:Mean age of hypertensive cases was 23.2 ± 0.52 years while that for controls was 23.9 ± 1.16 years. Significant differences were found in serum lipoproteins. Women having eclampsia had 28.8%, 29.5%, 31.1%, 32.9% and 65.3% higher, low density lipoprotein-cholesterol (LDLC), triglycerides (TG), total cholesterol (TC):high density lipoprotein-cholesterol (HDLC) ratio, LDLC: HDLC ratio and TG: HDLC ratio respectively as compared to the control group. The HDLC concentrations, HDLC: VLDLC ratio and apolipoprotein-A1 level were 26.9%, 56.6% and 27.9% respectively, lower in the patient group as compared to the controls.Conclusion:This study suggests that evaluation of lipoprotein concentrations during antenatal period can be helpful in the early detection and prevention of developing eclampsia.

Highlights

Eclampsia is a complex multisystem hypertensive disorder seen worldwide during late pregnancy and is a leading cause of maternal and fetal morbidity and mortality.[1]
Mean age and gestational age of the patient group was comparable with the control group, while systolic and diastolic blood pressure of the patient group was considerably raised and was highly significant when compared with the control group (Table-I)
Women having eclampsia had 28.8%, 29.5%, 31.1%, 32.9% and 65.3% higher, low density lipoprotein-cholesterol, triglycerides, total cholesterol:high density lipoprotein-cholesterol ratio, low density lipoprotein-cholesterol:high density lipoproteincholesterol ratio and triglycerides:high density lipoprotein-cholesterol ratio respectively as compared to the control group

Summary

Introduction

Eclampsia is a complex multisystem hypertensive disorder seen worldwide during late pregnancy and is a leading cause of maternal and fetal morbidity and mortality.[1]. The risk of developing pregnancy induced hypertension (PIH) increases with increasing age.[2] It is usually associated with placental hypoxia and dysfunction.[3]. It is characterized by blood pressure of 140/90 mm of Hg or rise in systolic blood pressure of more than 30mm of Hg or diastolic blood pressure of more than 15mm of Hg after 20 weeks of gestation accompanied by proteinurea ≥ 300mg / 24 hrs or greater or equal to 1+ or 100mg /dl by dipstick response.[4,5]. In Berhampur, Orissa, India maternal deaths due to PIH was 32% which is twice the national incidence of India.[8,9]

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Conclusion