Predictive value of serum uric acid levels for adverse perinatal outcomes in preeclampsia (original) (raw)
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Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2014
Elevated serum uric acid is commonly observed in women with preeclampsia, but its utility in predicting adverse outcomes has recently been disputed. Our goal was to analyze data from a large cohort of women with preeclampsia to determine the utility of serum uric acid in predicting adverse maternal and perinatal outcomes. Data were obtained from an ongoing international prospective study of women admitted to hospital with preeclampsia (Pre-eclampsia Integrated Estimate of RiSk). Univariate logistic regression was used to determine the relationship between serum uric acid concentration (both absolute and gestational-age corrected [Z score]) and adverse outcomes (maternal and perinatal). Analyses were conducted to compare cohorts of women with preeclampsia as defined by hypertension and proteinuria versus hypertension and hyperuricemia. Uric acid Z score was associated with adverse perinatal outcome (OR 1.5; 95% CI 1.4 to 1.7) and had a point estimate > 0.7 (area under the curve re...
High Serum Uric Acid Levels in Preeclampsia and Perinatal Outcome
2021
Hypertensive disorders of pregnancy are the most frequent medical condition that comes across during pregnancy and the medical and economic burden of the condition on the women and society is very high. The working group of the NHBPEPNational High Blood Pressure Education Program classified hypertensive disorders of pregnancies as: Gestational Hypertension, preeclampsia and eclampsia syndrome, preeclampsia superimposed on chronic hypertension and chronic hypertension. Uric acid is a product of purine degradation catalyzed by the enzyme xanthine oxidase and in humans most circulating uric acid is produced in the liver. Uric acid concentrations are influenced by several factors like high protein diet, alcohol consumption, and increased cell turn over, enzyme defects in purine metabolism, altered kidney function, etc. The serum level of uric acid rises preceding the signs and symptom of preeclampsia. Various biomarkers have been tried to predict the outcomes of preeclamptic pregnancies...
Uric Acid as a Pathogenic Factor in Preeclampsia
Placenta, 2008
Hyperuricemia is a common finding in preeclamptic pregnancies evident from early pregnancy. Despite the fact that elevated uric acid often pre-dates the onset of clinical manifestations of preeclampsia, hyperuricemia is usually considered secondary to altered kidney function. Increased serum uric acid is associated with hypertension, renal disease and adverse cardiovascular events in the non-pregnant population and with adverse fetal outcomes in hypertensive pregnancies. We hypothesize that an elevated concentration of uric acid in preeclamptic women is not simply a marker of disease severity but rather contributes directly to the pathogenesis of the disorder. Using epidemiological and experimental evidence, gained largely outside of pregnancy, we will propose pathogenic roles for uric acid in preeclamptic pregnancies. Uric acid's ability to promote inflammation, oxidative stress and endothelial dysfunction will be highlighted with discussions of the potential impact on placental development and function and maternal vascular health.
Innovative publication, 2016
Background: Preeclampsia is one of the common conditions of unknown etiology which increases the risk of maternal and perinatal morbidity and mortality. According to some studies, serum uric acid lacks sensitivity and specificity as a diagnostic tool whereas another group of the researchers indicated uricemia as a predictor of preeclampsia in pregnant ladies. Objective: The present study was designed to assess whether serum uric acid can be used as a biochemical indicator or not, in pregnancy induced hypertensive (PIH) patients. Study period & Method: Total number of 98 PIH patients admitted in GMERS Medical College, Dharpur, from Dec 2013 to Feb 2015 were included in this study and 60 normal healthy pregnant ladies served as control. Serum uric acid levels were estimated using modified Trinder's test. Results: Out of the 98 cases mild preeclamspsia was 60(61.2±%), severe Preeclampsia 24 (24.5%) and eclampsia 14(14.3%). Serum Uric acid levels significantly increased with the severity of PIH, normal pregnant women (4.58±0.37), mild preeclampsia (5.32+0.40), severe preeclampsia (6.29±0.57) and eclamspsia (7.88±1.26). Out of these women with uric acid levels more than 5.5mg/dl was seen in 28(46.6%) mild preeclampsia, 19(79.2%) severe preeclampsia and 12 (85.7%) eclampsia. Maternal mortality was observed in 05(5.1%)PIH cases and out this 04(80) had uric acid level > 5.5mg/dl. Perinatal mortality was observed in 25 (25.1%) cases, out of these 19(76%) were stillbirths and 06(24%) were neonatal deaths. Out of the 25 perinatal deaths 18(72%) had uric acid level >5.5mg/dl. Conclusion: Serum uric acid level could be used as a biochemical indicator of preeclampsia/eclampsia and its complications.
A STUDY OF SERUM URIC ACID LEVELS IN PREECLAMPSIA
Background: The present study concentrate to get significant association of serum uric acid levels with pre-eclampsia and PIH and also between serum uric acid and severity of disease. Material and Methods: 80 Patients diagnosed as having Pre-eclampsia and 80 controls with similar age group were studied after taking their consent. Blood samples were collected under aseptic precautions in plain vacutainer for serum uric acid estimations. Uric acid estimation was done by Uricase Peroxidase Method on Fully Automated Biochemistry Analyzer Miura 300. Results: The observed mean serum uric acid levels in preeclampsia was 7.52±0.77 mg/dl as compared to 3.70±0.94 mg/dl in controls. Conclusion: High serum uric acid levels could be a useful indicator of the maternal and fetal complication in hypertensive patients.
Assessing the Role of Uric Acid as a Predictor of Preeclampsia
Frontiers in Physiology, 2022
We assessed the diagnostic utility of uric acid for the prediction of preeclampsia. An observational prospective approach was carried out during 2014. Preeclamptic women were classified into 4 groups accordingly to the onset of preeclampsia and the presence of intrauterine growth restriction (IUGR). Serum uric acid levels, urea, and creatinine were measured. Receiver operating curves (ROC) of the uric acid levels ratio (UAr) between a dosage before and after the 20th week of gestation were performed. One thousand two hundred and ninety-third pregnant women were enrolled in this study. Eight hundred ten had non-complicated pregnancies, 40 preeclampsia, 33 gestational hypertension, and 20 IUGR without preeclampsia. Uric acid significantly raised after 20 weeks of gestation in women who develop preeclampsia before 34 weeks (Group A) or in those who develop preeclampsia after 37 weeks associated with IUGR (Group C). In women who develop preeclampsia after 34 weeks without IUGR (Groups B...
2018
Introduction: Hypertensive disorders of pregnancy is a broad spectrum entity complicating pregnancy from 2 nd trimester onwards with increasing prevalence leading to unfavourable maternal & foetal outcome Aim: 1. To study the accuracy of elevated S.uric acid levels as a predictor of hypertensive disorders of pregnancy& its complications. 2. To evaluate the maternal & perinatal outcome in relation to raised S. uric acid levels in women with PIH. Methodology: Hundred pregnant women in the age group of 20-40 yrs, in the 3 rd trimester of pregnancy, diagnosed as cases of pre ecclampsia, were included in the study after prior informed consent. The patients were investigated & followed up. Records of maternal & foetal outcome and the complications arising due to pre ecclampsia were maintained. The results were correlated with levels of S.uric acid and statistically analysed. Results:The study was conducted in two groups of sample size 50 each with S. uric acid> 6.0mg/dl in group A &<...
Analysis of Serum Uric Acid Levels in Early Second Trimester as an Early Predictor for Preeclampsia
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Hypertensive disorders complicate 5-10% of all pregnancies. Screening for these factors in the second trimester of pregnancy will help in early detection of hypertensive disorders of pregnancy, thus enabling. 1. Early identification of patients at risk of developing preeclampsia and eclampsia. 2. Prophylactic medication to prevent hypertension or to reduce its severity. 3. Proper antenatal care. The aim of the study is to study the accuracy of serum uric acid levels in early second trimester (14-20 weeks) as early predictor of preeclampsia. MATERIALS AND METHODS 100 pregnant normotensive women between 14-20 weeks gestation with singleton pregnancy irrespective of parity were selected randomly and serum levels of uric acid was estimated. Regular follow up of the cases was done till delivery. Number of cases developing preeclampsia was noted. Results were analysed statistically. RESULTS Out of the 100 patients enrolled in the study, 11 developed preeclampsia while rest 89 remained normotensive. Mean value of uric acid in preeclampsia cases was 6.28±0.86 mg/dL while that in normotensive cases was 3.42±0.94 mg/dL. This result was statistically significant. CONCLUSION Serum uric acid level at 14-20 weeks of gestation was significantly raised in the cases who developed preeclampsia as compared to those who remained normotensive. Hence, serum uric acid estimation at 14-20 weeks of gestation could be used as an effective parameter for predicting preeclampsia.