Evaluation of Serum Uric Acid levels among Hypertensive Pregnant Women in Khartoum State
Abstract
Background: Hypertensive disorders complicate 5–10% of all pregnancies and contribute greatly to maternal morbidity and mortality. Hyperuricemia has played a significant role in the pathogenesis of the disease and often precedes clinical manifestations.
Objective: in this study, we aimed to evaluate the serum uric acid levels in hypertensive pregnant women compared to normotensive pregnant women with different trimesters.
Materials and Methods: An analytical comparative hospital based study, the study conducted in Khartoum state, during the period from April to October 2019. A total of 210 pregnant women were enrolled, 90 normotensive pregnant women with different trimesters, 90 preeclampsia women and 30 pregnant women with eclampsia. All Serum uric acid concentrations were estimated by enzymatic method in fully Automated Biochemistry Analyzer (Mindary, china).
Results: Among the normotensive pregnant women, the percentage of primigravidae was 36(40%) and the multigravidae was 54 (60%), and in the group of pregnant women with preeclampsia, the primigravidae was 41(34%) and the multigravidae 49 (66%), while it was 9(30%) and 21 (70%) respectively In the group of pregnant women with eclampsia, the primary gravida 9(30%) and the multigravida 21 (70%). Serum uric acid level was significantly increased in pregnant women with preeclampsia and eclampsia compared with normotensive pregnant women (p = 0.000). Also the serum uric acid was significantly increased in pregnant women in the third trimester compared to first and second trimester normal pregnant women (p= 0.000).
Conclusion: Serum uric acid had a highly significant increase in hypertensive pregnant women compared with normotensive pregnant women. The study observed that the serum uric acid may have a predictive marker role of hypertensive pregnant women.
References
2. Many A, Hubel CA, Roberts JM. Hyper Uricaemia and xanthine oxidase in preeclampsia, revisited. Am J Obstet Gynecol. 1996; 174 (1): 288–91.
3. Powers RW, Bodnar LM, Ness RB, et al. Uric acid concentrations in early pregnancy among preeclamptic women with gestational hyperuricemia at delivery. Am J Obstet Gynecol. 2006; 194(1):160.
4. Johnson RJ, Kang DH, Feig D, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 2003;41:1183–90.
5. Soukup M, Biesiada I, Henderson A, et al. Salivary uric acid as a non invasive biomarker of metabolic syndrome. Diabetol Metab Syndr. 2012; 4(1):14.
6. Cunningham FG, Leveno KJ, BlownSL, Hath JC, Gilstrap LC, Wenstrom KD. Williams Obstetrics 22edition McGraw Hill 2005 : 761-808.
7. Kang DH, Finch J, Nakagama T, Karumanchi Sa, Kanellis J. Uric acid, endothelial dysfunction and preeclampsia: searching for pathogenetic link. J. Hyperten 2004; 22 :219-25.
8. Satya Prakash, Sharma N, Kumari P, Kumar A. Serum Uric Acid as Marker for Diagnosing Preeclampsia. Int J Pharm Sci Res 2012; Vol.3(8): 2669-2675.
9. Kang D, Finch J, Nakagawa T, et al: Uric acid, endothelial dysfunction and pre-eclampsia: searching for a pathogenetic link. J Hypertension 2004; 22:229-235.
10. Watanabe S, Kang DH, Feng L, et al: Uric acid, hominid evolution, and the pathogenesis of salt-sensitivity. Hypertension 2002; 40:355-360.
11. Kumari Sweta, Ravi Bhushan Raman, Vinod Shankar, Shashi Bhushan Kumar, Gyan Bhushan Raman. Comparative assessment of serum uric acid levels in pregnancy induced hypertension females and normal pregnant females. International Journal of Medical and Health Research. 2019. Volume 5; Issue 1; January; Page No. 236-238.12. Mustaphi R, Gopalan S, Dhaliwal L, Sarkar AK. Hyperuricemia and pregnancy induced hypertension Reappraisal. Ind. Jmed Sci. 1996; 3(50):68-71.
13. Chesley L, Williams L. Renal glomerular and tubular functions in relation to the hyperuricemia of preeclampsia and eclampsia. Am J of Obst Gynecol.1945; 50:367-75.
14. Bhatt AM, Barfiwala J. Study of some aspects in pregnancy induced hypertension. J Obst Gynecol India.1985; 36:1050-54.
15. Ghosh T, Das P. Management of eclampsia. J ObstGynecol India. 1987; 37:121-26.
16. Sabai BM, Spinnato JA, Watson DL, Hill GA, Anderson GD. Pregnancy outcome in 303 cases with severe preeclampsia. Obst Gynecol, 1984, 64.
17. Pramanik T, Khatiwada B, Pradhan P.Serum uric acid level in normal pregnant and preeclamptic ladies: a comparative study. Nepal Med Coll J 2014;16(1): 30-32.
18. Salako BL, Odukogbe AT, Olayemi O etal. Serum albumin, creatinine, uric acid and hypertensive disorders of pregnancy. East African Medical Journal 2003;80 (8):424-8.
19. Bainbridge SA, Roberts JM. Uric acid as a pathogenic factor in preeclampsia.Placenta 2008; 29:67-72.
20. Roger A. McMaster-Fay. Preeclampsia is a disease of oxidative stress resulting from the catabolism of DNA (primarily fetal) to uric acid by xanthine oxidase in maternal liver: A hypothesis. Bioscience Hypotheses 2008;1:35e 43.
21. Lam C, Lim KH, Kang DH, Karumanchi. Uric acid and preeclampsia. In: seminars in nephrology WB Saunders 2005; 25(1):56-60.
22. Karabulut AB, Kafkash A, Burak F,Gozukara EM. Maternal and fetal plasma adenosine deaminase, xanthine oxidase and malon- dialdehyde levels in preeclampsia.Cell Biochem Funct. 2005; 23:279e83.
23. Amini E, SheikhM, Hantoush Zadeh S,Shariat M, Abdollahi A, Kashanian M.Maternal hyper uri- cemia in normotensive singleton pregnancy, a prenatal finding with continuous perinatal and postnatal effects, a prospective cohort study. BMC
Pregnancy and Childbirth 2014:14:104.
24. Eltayeb Mohamed Ahmed Tayrab and Sohinda Saladdin. Biochemical and hematological evaluations in sudanese women with preeclampsi a, Asian Journal of Pharmaceutical Analysis and Medicinal Chemistry, 4(1), 2016, 1-7.
25. Sangeeta N, Shaini L, Basar G, Soni Devi, Changi V, et al. Serum Uric Acid and Homocyste- ine as Predictors of Pre-eclampsia. JDiabetes Metab.2013. 4: 259.