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 cen-tre of Northern India over seven months (October 2016-May 2017) on 110 women admitted with a Hypertensive disorder of pregnancy (Gestational hypertension, Pre-eclampsia, 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 re-mained stable in post-partum period, 17 (34.69%) women with severe pre-eclampsia and 15 (57.69%) with eclampsia re-quired 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 de-livery was a lower segment cesarean section (50.90%).Conclusion: Significant correlation was observed between maternal serum uric acid, disease severity and maternal outcome.
Highlights
Worldwide Hypertensive disorder of pregnancy (HDP) is a major cause of maternal and perinatal morbidity and mortality [1,2,3] and complicates around 2-10% of all pregnancies [4]
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
Significant correlation was observed between maternal serum uric acid, disease severity and maternal outcome
Summary
Worldwide Hypertensive disorder of pregnancy (HDP) is a major cause of maternal and perinatal morbidity and mortality [1,2,3] and complicates around 2-10% of all pregnancies [4]. The most common reason for such a high maternal and perinatal morbidity and mortality associated with HDP is the. 1875-6506/19 $58.00+.00 unavailability of precise and specific test that can identify pregnant women at risk of developing HDP [9]. One such biochemical marker that can be used to assess the severity of HDP and its effect on the maternal and fetal outcome to a large extent is maternal serum uric acid level. There are many reasons for raised serum uric acid levels in women with HDP, which include impaired clearance from kidneys, increased tissue breakdown, acidosis and increased activity of xanthine oxidase/dehydrogenase enzyme [14, 15]. The main reason behind impaired renal clearance of uric acid is reduced glomerular filtration rate, increased absorption and decreased secretion leading to rais-
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