Plasma purine turnover metabolites in women with normal pregnancy and pregnancy complicated with induced hypertension as compared to fetal well-being indices.

Abstract

The purpose of this study was to determine the association between maternal plasma purine bases levels and fetal well-being indices. The research included pregnant women with pregnancy-induced hypertension (PIH) and women with physiologic pregnancy between 32nd and 41st week of gestation. To characterize the pregnant women, their age, number of gestations, and blood pressure values were used. To evaluate condition of the fetus, the values of biophysical profile and FHR tracing were assessed. The purine bases (hypoxanthine, xanthine and uric acid) concentrations in plasma were determined using high pressure chromatography. Hypoxanthine levels, oxypurine pool, hypoxanthine to xanthine molar ratio and the ratio of uric acid to the oxypurine pool were significantly different in patients with PIH in comparison with women with physiologic pregnancy. It was found that increased adenyl nucleotide catabolism in the PIH group can be related to fetal well-being indices, particularly to FHR tracings. Increased percentages of suspected and pathologic FHR tracings were found in patients with PIH in comparison with physiologic pregnancy. The unfavorable influence of increased metabolism of adenyl nucleotides on the condition of the fetus was further confirmed by significant negative correlation between the oxypurine pool and the FHR tracings. The multiple regression analysis choosing the optimal subgroup of independent variables showed significant correlation between the parameters describing the well-being of the fetus and newborn and the levels of inosine, uric acid and xanthine. In the group of women with physiologic pregnancy, the most significant correlation was found in the diastolic blood pressure and hypoxanthine levels.