Abstract
Objective: To estimate the serum homocysteine and uric acid levels in normal and pre-eclamptic patients and to find out any correlation between these parameters and pre-eclampsia Study design and setting: Cross-sectional study; Dept. of Biochemistry in collaboration with Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences (RIMS); Imphal (Manipur), India. Methods: Data collected from 50 pre-eclamptic pregnant women and 25 normotensive pregnant women admitted in Antenatal ward, Department of Obstetrics and Gynaecology, RIMS Hospital. The blood samples were collected from these patients and analyzed for serum homocysteine and uric acid level. Results: The serum homocysteine and uric acid levels were found to be significantly higher in preeclamptic cases than in normal controls. Mean ± SD of uric acid and homocysteine levels were 8.82 ± 1.68 mg% and 10.32 ± 2.52 μmol/l respectively in the cases compared to 4.06 ± 0.96 mg% and 3.55 ± 1.25 μmol/l in the controls. A positive correlation was found between the serum uric acid level, homocysteine and blood pressure. Thus the study showed a strong association between increased uric acid, blood pressure and homocysteine levels.
Highlights
Hypertension is one of the common complications during pregnancy and contributes significantly to maternal and perinatal morbidity and mortality
Our study shows blood pressure is higher in the cases compared to controls and the difference is highly significant as shown in table 9
The results of this study confirm the hypothesis that hyperuricemia and hyperhomocysteinemia are indirect risk factors for preeclampsia
Summary
Hypertension is one of the common complications during pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. Pre-eclampsia is a type of hypertensive disorder complicating pregnancy. It is a multisystem disorder of unknown etiology characterized by development of hypertension to the extent of 140/90 mmHg or more with proteinuria after the 20th week in a previously normotensive and non-proteinuric patient. Uric acid (UA) is the major end-product of purine metabolism. The cause of hyperuricemia in pre-eclampsia has been attributed to either a decreased excretion or to an increased production of uric acid. Decreased uric acid clearance, reflected by altered tubular function has been documented, while in 1990 Fay proposed an increased breakdown of purines in the placenta as a possible explanation for the overproduction of uric acid [2]. Hyperuricemia is one of the most consistent and earliest detectable changes in pre-eclampsia and has been cited as a better predictor of fetal risk than blood pressure [3,4]
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