Evaluation Of Uric Acid As A Marker For Maternal And Fetal Outcomes In Nulliparous Women With Pre-Eclampsia At Irrua Specialist Teaching Hospital, Irrua, Edo State - (Pages 14-27)
Ohwowhiagbese Ejomafuvwe, Reuben Agbons Eifediyi, Governor Okome, Mojeed Momoh, Joseph Ikheloa, Joseph Okoeguale and Joseph Eigbefoh
Department of obstetrics and gynaecology, Irrua Specialist Teaching Hospital, Irrua and College of Medicine, Ambrose Alli University, Ekpoma-Nigeria
Background: Preeclampsia is one of the leading cause of maternal and fetal morbidity and mortality worldwide. The early identification of patients with an increased risk for preeclampsia is therefore one of the most important goals in obstetrics. The availability of highly sensitive and specific physiologic and biochemical markers would allow not only the detection of patients at risk but also permit a close surveillance, an exact diagnosis, timely intervention. Today, several markers may offer the potential to be used, either singly or more preferably in combination analysis, as predictors or diagnostic tools.
Objectives: The aim of the study was to assess the usefulness of uric acid as biochemical marker of maternal, fetal and neonatal outcome in patient with preeclampsia at delivery.
Materials and Methods: This was a prospective case control study involving 82 parturients (forty one (41) with preeclampsia and forty one normotensives) who met the inclusion criteria were recruited into the study. The parturients were categorized based on the presence of gestational hypertension (H), proteinuria (P)and hyperuricemia (U) into four(4) diagnostic criteria/ categories namely presence of both gestational hypertension and proteinuria (HP), presence of gestational hypertention, proteinuria and hyperuricaemia (HPU), presence of hyperuricemia alone (u) and normal values of blood pressure, urinary protein and maternal serum uric acid (NNN).
Results: The study showed that preeclampsia with associated hyperuricaemia was associated with increased small for gestational age (SGA) babies (p<0.001), preterm deliveries (p<0.001), low birth weight (p<0.001) and admission in special care baby unit (SCBU) (p<0.001). There were also increased adverse maternal outcomes in this group of patient including increased medically indicated caesarean section (p<0.001), maternal seizure (p<0.001), thrombocytopenia (p<0.019), severe headache (p<0.001), proteinuria (P<0.001) and visual disturbances (p<0.046), in rural Nigerian parturients.
Conclusions: The study revealed that serum uric acid which is simple and inexpensive, should be used in identifying pregnancy with gestational hypertension at risk of infants and maternal complications in Nigeria Sub rural population.
Keywords: Gestational hypertension, proteinuria, hyperuricemia.