Maternal serum ischemia modified albumin as a marker for hypertensive disorders of pregnancy: a pilot study (original) (raw)
Related papers
Ischemia Modified Albumin (Ima) in Serum as a Biochemical Marker in Pre-Eclampsia
2019
BACKGROUND: Pre-eclampsia (PE) , a pregnancy specific disorder is the most common cause of foetal and maternal death. Yet no specific prevention and treatment is available. Ischemia Modified Albumin (IMA) has emerged as a marker in different diseases where ischemia is the origin or consequence behind disease pathology. Reliable biochemical markers for prediction and diagnosis of PE can have a better impact on maternal health and several of the markers have been suggested till now. MATERIALS & METHODS: 30 patients with PE were selected for the study and compared with 30 pregnant healthy controls. IMA were estimated in these patients. The results were then statistically analysed. RESULTS: IMA levels were found significantly raised in PE patients as compared to normal pregnant controls (p value<0.001). CONCLUSION: IMA which is generated by hypoxia/ischemia driven oxidative stress is also raised in PE and hence can be used as a biomarker in PE. Further studies are needed to establish...
Cureus
Background Ischemia-modified albumin (IMA) is looked upon as a newer marker of myocardial ischemia. There is a paucity of literature however with regard to studies correlating levels of IMA in patients with hypertensive disorders of pregnancy. The present study therefore aimed at estimating the levels of IMA in patients with gestational hypertension and assessing its utility in predicting hypertensive disorders of pregnancy. Methods The present study was a hospital-based case-control study conducted in the Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Nagpur. IMA was estimated in 30 controls (Group I) and 20 cases of gestational hypertension (Group II) using a spectrophotometric assay detecting free unbound Cobalt left behind. The clinical data and lab results were presented as mean ± SD. Student's t-test was applied and Pearson's correlation coefficient was calculated. A value of p < 0.05 was taken as statistically significant. The ROC (Receiver Operator Characteristic) curve was used to establish the cutoff of serum IMA levels in pregnancy-induced hypertension (PIH). Results There was no significant difference in age and period of gestation (POG) at the time of sample collection between the groups. There was a significant difference in the systolic and diastolic blood pressures (BPs) of both groups. The mean level of serum IMA was significantly higher in cases of gestational hypertension (0.88 ± 0.14 absorbance units {ABSU}) as compared to controls (0.69 ± 0.08 ABSU) (p<0.001). On correlation analysis, the systolic and diastolic BPs were found to be highly positively correlated with serum IMA levels (p<0.001). ROC curve analysis suggested that at a cutoff of 0.73 ABSU, IMA has 85% sensitivity and 80% specificity for predicting gestational hypertension. Conclusion Statistically significant results of serum IMA levels obtained in gestational hypertension which falls on the lesser severe spectrum of the disease imply that serum IMA can be used for early diagnosis of gestational hypertension and impending Pre-eclampsia (PE) and Eclampsia.
IP innovative publication pvt. ltd, 2019
Introduction: Pre-eclampsia (PE) a pregnancy specific disease, the most common cause of fetal and maternal death yet, no specific prevention and treatment is available. Reliable biochemical markers for prediction and diagnosis of PE can have a better impact on maternal health and several of these markers have been suggested till now. Recently Ischemia Modified Albumin (IMA) has emerged as a marker in different diseases, where ischemia is the origin or consequence behind disease pathology. Materials and Methods: 30 patients with PE were selected for the study and compared with 30 pregnant healthy controls. IMA IMA/albumin with other routine biochemical markers was estimated in these patients. The results were then statistically analysed. Results: IMA levels were found significantly raised in PE patients as compared to normal pregnant controls (p value<0.001) A significant correlation was also found between IMA levels and MDA levels in PE (r=+0.3 p value<0.05). Conclusion: IMA generated by hypoxia/ischemia driven oxidative stress is also raised in PE, hence can be used as a biomarker in PE. Further studies are needed to establish the relationship between IMA, disease process and its association with severity of the disease.
Role of maternal serum ischemia modified albumin as a biochemicalmarker in preeclampsia
Biomedical Research-tokyo, 2014
Preeclampsia (PE) a pregnancy specific disorder is the most common cause of fetal and maternal death yet no specific prevention and treatment is available. Reliable biochemical markers for prediction and diagnosis of PE can have a better impact on maternal health and several of the markers have been suggested till now. Recently Ischemia Modified Albumin (IMA) has emerged as a marker in different diseases where ischemia is the origin or consequence behind disease pathology. Therefore this study was undertaken to evaluate the role of maternal serum IMA in PE and its correlation with the oxidative stress. 45 patients with PE were selected for the study and compared with 31 pregnant healthy controls. IMA IMA/Albumin and Malondialdehyde (MDA) with other routine biochemical markers were estimated in these patients. The results were then statistically analysed. IMA levels were found significantly raised in PE patients as compared to normal pregnant controls (p value <0.001). A significa...
IMA and IMAR in serum and saliva of preeclampsia – a preliminary study
Hypertension in Pregnancy, 2014
Introduction: Oxidative stress could play a role in the development of preeclampsia. Ischemia modified albumin (IMA) is a oxidatively modified form of albumin. Objective: To evaluate the levels of salivary and serum IMA and IMA: albumin ratio (IMAR) in preeclampsia and with its severity and investigate their correlation with the fetal birth weight. Methods: This case control study was conducted on 50 preeclamptic (32 mild and 18 severe cases) and 50 normal pregnant controls. Blood and saliva were obtained to measure albumin, IMA and IMAR was calculated. Results: serum and salivary IMA and IMAR were significantly increased in preeclampsia. Although the increase in serum was in accordance with the severity, it was not so in the saliva. Yet, salivary IMAR showed significant difference between controls and mild preeclampsia. There was a negative correlation between IMA and albumin in both serum and saliva. A weak negative correlation was seen between the serum IMAR and fetal birth weight (r = À0.293; p50.05), but not with salivary IMAR. Conclusion: This study is an evidence for involvement of oxidative stress in the pathogenesis of preeclampsia, which is reflected in serum and saliva. Salivary IMAR could be a better marker for early prediction of preeclampsia.
Study of Serum IMA and Electrolytes in Patients of Pre-eclampsia in Central India
2019
Background: Pre-eclampsia (PE) a pregnancy specific disorder is the most common cause of fetal and maternal death, yet no specific prevention and treatment is available. Reliable biochemical markers for prediction and diagnosis of PE can have a better impact on maternal health and therefore several markers have been suggested till now. Recently Ischemia Modified Albumin (IMA) has emerged as a marker in different diseases where ischemia is the origin or consequence behind disease pathology. The normal sodium level is in the range of [137-145 mmol/L] and that of the potassium is [3.5-5.0 mmol/L]. Materials & methods: 30 patients with PE were selected for the study and compared with 30 pregnant healthy controls. IMA, IMA/albumin ratio & Serum Electrolytes were estimated in these patients. The results were then statistically analyzed. It was a record based cross-sectional comparative study, carried out in the department of Biochemistry at Shri Shankracharya Institute of Medical Sciences...
Review: Biochemical markers to predict preeclampsia
Placenta, 2012
Worldwide the prevalence of preeclampsia (PE) ranges from 3 to 8% of pregnancies. 8.5 million cases are reported yearly, but this is probably an underestimate due to the lack of proper diagnosis. PE is the most common cause of fetal and maternal death and yet no specific treatment is available. Reliable biochemical markers for prediction and diagnosis of PE would have a great impact on maternal health and several have been suggested. This review describes PE biochemical markers in general and first trimester PE biochemical markers specifically. The main categories described are angiogenic/antiangiogenic factors, placental proteins, free fetal hemoglobin (HbF), kidney markers, ultrasound and maternal risk factors. The specific biochemical markers discussed are: PAPP-A, s-Flt-1/PlGF, s-Endoglin, PP13, cystatin-C, HbF, and a 1 -microglobulin (A1M). PAPP-A and HbF both show potential as predictive biochemical markers in the first trimester with 70% sensitivity at 95% specificity. However, PAPP-A is not PE-specific and needs to be combined with Doppler ultrasound to obtain the same sensitivity as HbF/ A1M. Soluble Flt -1 and PlGF are promising biochemical markers that together show high sensitivity from the mid-second trimester. PlGF is somewhat useful from the end of the first trimester. Screening pregnant women with biochemical markers for PE can reduce unnecessary suffering and health care costs by early detection of mothers at increased risk for PE, thus avoiding unnecessary hospitalization of pregnant women with suspect or mild PE and enabling monitoring of the progression of the disease thereby optimizing time for delivery and hopefully reducing the number of premature births.
The potential value of diagnostic and predictive serum biomarkers for preeclampsia
Romanian Journal of Morphology and Embryology
Background: Preeclampsia (PE), one of the classes of hypertensive pregnancy disorders, is one of the three causes of maternal morbidity and mortality worldwide. The angiogenic and anti-angiogenic factors are useful markers in predicting and diagnosing PE. Aim: This study aims to detect and measure the serum level of some biomarkers [hypoxia-inducible factor-1 subunit alpha (HIF-1A), vascular endothelial growth factor (VEGF), interferon-gamma-inducible protein of 10 kDa (IP-10), matrix metalloproteinase-13 (MMP-13)] in patients with PE and their correlation with the severity of the disease, to find a good predictor for PE. Patients, Materials and Methods: This prospective study aims to monitor 48 pregnant women who address obstetric consultation and who present risk factors for PE, and a control group with characteristics similar to the study group. Patients were divided into three groups: Group I (n=15) including normal pregnant (NP) women with blood pressure <140/90 mmHg, without proteinuria, Group II (n=18) including patients with mild PE (MildPE), Group III (n=15) including patients with severe PE (SeverePE). The analysis of serum biomarkers was based on a quantitative sandwich enzyme-linked immunosorbent assay (ELISA), according to the manufacturer's instructions. Results: In our study, we found that all biomarkers investigated have higher concentrations in the serum of patients with SeverePE and MildPE than those in the control subjects (Group I, NP), the concentrations were increasing along with the disease activity. The means concentrations of HIF-1A, VEGF, IP-10, MMP-13, better correlated with indices in SeverePE group than in MildPE group. We found that VEGF was the biomarker that best correlates with indices that assess the severity of PE. The best separation of patients with SeverePE from those with MildPE can be done with the help of MMP-13 (82% accuracy), followed by VEGF (80.40% accuracy) and the least good detection being done by dosing IP-10. Conclusions: We can say that, due to high specificity diagnostic accuracy, determination of serum concentrations of MMP-13 and VEGF, could be useful in the diagnosis and distinguishing of patients with SeverePE and may prove useful in the monitoring of the disease course.
Ischemia-modified albumin in preterm infants born to mothers with pre-eclampsia
Pediatrics International, 2018
Background: Preeclampsia (PE) is at increased risk for maternal and/or fetal mortality or serious morbidity. PE is associated with ischemia and increased oxidative stress in placenta, which may lead to modification of plasma albumin to ischemia-modified-albumin (IMA). We aimed to investigate of IMA and hematological parameters in premature infants born to mothers with normal pregnancy and preeclampsia, and also in their mothers. Methods: Twentyfive pregnants with PE and their premature newborns as PE-group, and 25 normotensive pregnants and their premature newborns as control-group were included the study. Preterms are classified as small for gestational age (SGA) and non-SGA according to Fenton preterm growth chart. IMA, complete-blood-counts (CBCs), liver-function-tests (LFTs), renal-function-tests (RFTs), albumin, and C-reactive-protein levels were measured in pregnants' serum samples just before the birth and measured in their newborns' cord and serum samples at 6 th and 24 th hour of postnatal life. Clinical and demographic data of all groups were recorded. Results: While IMA, LFTs and RFTs values were significantly increased in PE-group when compared with control-group, albumin and CBC values were significantly lower in PEgroup. 40% of PE-group's newborns were SGA, and 30% of them had severe-SGA (birthweight<3 rd percentile). Cord-IMA levels were significantly increased in preterms and SGA preterms born to mothers with PE compared to control-group. No mothers and neonates died. Conclusion: This study demonstrated that serum IMA levels in addition to an increased birth rates of SGA were significantly increased in preeclampsia. We suggest that cord blood IMA levels might be a predictive biomarker for SGA preterms.
Serum Markers for the Prediction of Preeclampsia
Journal of Neurology & Neurophysiology, 2014
Preeclampsia is one of the major causes of perinatal morbidity and mortality. There is urgent need for a first trimester marker for the prediction of the disease. Ultrasonographic markers when used alone are not very sensitive. Several biochemical serum markers have been investigated as possible predictors in the first and second trimester of pregnancy. The markers which have been studied extensively are both angiogenic and antiangiogenic factors as well as factors related to the process of placentation. However, the biochemical markers when they are used alone are not extremely effective for the prediction of PE. The combination of these markers with other predictors such as maternal history, clinical features, risk factors, demographic characteristics, uterine arteries Doppler will develop in the future more effective prediction models.