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Background: Measurement of variety of biological, biochemical and biophysical markers in pregnancy implicated in the pathophysiology of preeclampsia have been proposed to predict its development.
Aim: To evaluate the accuracy of combined measure of maternal serum uric acid level and quantitative serum beta hCG versus serum beta hCG alone as prognostic indicators of pregnancy outcome among preeclamptic patients at the Federal Medical Centre, Yenagoa.
Methods: This is a hospital based prospective case control study by systematic sampling selection. The two groups comprised of 100 consecutive patients each, one with pre-eclampsia (study group) and the other without pre-eclampsia (control) admitted for management into the antenatal ward and labour ward over the seven-month period of the study. The values of their serum uric acid and beta hCG levels were evaluated on admission and followed up. Data entry and statistical analysis was done using statistical package for social science (windows version 22.0. SPSS Inc; Chicago, USA). Level of significance was set at P < 0.05.
Results: The mean quantitative serum β hCG level amongst the subjects (26776.6 ± 19590.5) was statistically significantly higher (p < 0.001) than the mean quantitative serum β hCG level amongst the control (7973.6 ± 4193.7). The prognostic accuracy in predicting pregnancy outcomes were: HELLP syndrome (0.33, 0.44), Eclampsia (0.50, 0.39), Acute Renal Failure (0.44, 0.33), IUGR (0.43, 0.39), IUFD (0.38, 0.27) and Birth Asphyxia (0.49, 0.38) respectively for combined measure of serum uric acid and serum β hCG, and serum β hCG alone.
Conclusion: Serum β hCG levels remains a useful prognostic indicator for feto-maternal outcome in preeclamptic women. However, combined measure of serum uric acid and serum β hCG level in prognosticating pregnancy outcome in preeclamptic women was shown to have a better accuracy than serum β hCG.
Kanagal DV, Rajesh A, Rao K etal. Levels of serum calcium and magnesium in preeclamptic and normal pregnancy: A study from coastal India. Journal of Clinical and Diagnostic Research. 2014;8(7):0001-0004.
Kharaghani R, Okhovat B, Cheraghi Z. Prevalence of preeclampsia and eclampsia in Iran. Archives of Iranian Medicine. 2016; 19(1):50-57.
Bergamo AC, Zeiger BB, Vidal DH. The epidemiology of preeclampsia in a reference hospital. Pregnancy Hypertension: International Journal of Women’s Cardiovascular Health. 2015;5: 114.
Kaklina EV, Ayala C, Callagha WH. Hypertensive disorder and severe obstetric morbidity in the united state of America. Journal of Obstetrics and Gynaecology 2009;113:1299-306.
Akhar S, Begum M, Ferdousi S. Calcium and Zink deficiency in preeclamptic women. Journal of Bangladesh Society of Physiologist. 2011;6(2):94-99.
Teklu S, Gaym M. Prevalence and clinical correlation of the hypertensive disorder of pregnancy at Tikur Anbassa Hospital, Addis Ababa, Ethiopian. Ethiopian Medical Journal. 2006;44(1):17-26.
Ebeigbe PN, Azike EN: Early onset pregnancy induced hypertension / eclampsia in Benin City, Nigeria. Nigerian Journal of Clinical Practice. 2010; 13(4):388-93.
Swati S, Ekele BA, Shehu CH. Hypertensive disorders in pregnancy among pregnant women in a Nigerian Teaching Hospital. Nigerian Medical Journal. 2014;55(5):384-388.
Mary E, Mabel E, Dorcas O. Prevalence of preeclampsia among pregnant women in the University of Calabar Teaching Hospital. Saudi Journal of Health Sciences. 2014;3(3):133-136.
Ekine AA, Jeremiah I, Harry TC, West OL. Factors influencing the prevalence of preeclampsia –Eclampsia in booked and unbooked patients in NDUTH. World Journal Medical Sciences. 2015;3(1):1-14.
World Health Organisation. The incidence of hypertensive disorders of pregnancy: In the hypertensive disorders of pregnancy. 1987;758:16-25.
Kalkunte S, Navers T, Norris W, Benerjee P. Presence of non functioning hCG in preeclampsia and rescue of normal pregnancy by recombinant hCG placenta. 2010;31:A216.
Chinedu N, Sefa A, Frederick S, Ozlem G. hCG: Biological functions and clinical applications. International Journal Molecular Sciences. 2017;18,2037.
Vandana Y, Verma A, Nagraj S. Serum level of beta human chorionic gonadotropin in pathogenesis of preeclampsia. International Journal of Biomedical and Health Care Science. 2016;6(2):219-225.
Razia S, Selina A, Nasima S. Association of serum uric acid with preeclampsia: A case control study. Delta Medical College Journal. 2013;1(2):46-50.
Patei T, Dudhat A. Relationship of serum uric acid level to maternal and perinatal outcome in patients with hypertensive disorders of pregnancy. Gujarat Medical Journal. 2014;69(2):45-47.
VAjZquez-RodrAquez JG, Rico-Trejo EI. Role of Uric Acid in Preeclampsia-Eclampsia. Ginecologia y Obstetricia de Mexico. 2011;79(5):292-297.
Cunningham AG, Kenneth JL, Steve LB. Pregnancy Hypertension in: William’s Obstetrics, 23rd Edition, Mc Graw-Hill Companies Inc. 2010;706-756.
SOGC Clinical Practice Guideline No.307, Diagnosis, evaluation and management of hypertensive disorders of pregnancy. Journal of Obstetrics and Gynaecology Canada. 2014;36(5):416-438.
Felix E, Olivier I, Pascal F. Blood uric acid level as a marker of increased risk of Eclampsia in Severe Preeclamptic patients: A Cross-Sectional Study in Two Tertiary Hospitals of Yaounde, Cameroon. Health sciences and disease. 2016;17(2): 07-11.
Sreelatha S, Bharathi A, Ramya S. Estimation of serum LDH and uric acid in preeclampsia and its correlation with maternal and perinatal outcome. International Journal of Advances in Case Reports. 2015;2(7):447-449.
Lincy J, Mathew G, Anju A. A review on estimation of serum LDH and uric acid in hypertensive vs normal pregnant woman and its correlation with maternal outcome in a tertiary care hospital. International Journal of Therapeutic Applications. 2016; 32:35-37.
Kooffrey ME, Ekoh M, Ekpoudom DO. The prevalence of preeclampsia among pregnant women in University of Calabar Teaching Hospital, Calabar. Saudi Journal Health Sciences. 2014;3(3):133-136.
Sotunsa J, Sharma S, Imaralu J, Tang L, Adepoju A. The hypertensive disorders of pregnancy in Ogun State, Nigeria: Preeclampsia in low and middle income countries. Pregnancy Hypertension: International Journal of Women’s Cardiovascular Health. 2016;6(3). Available:https://doi.org/10.10161j.preghy.2016.08.146
Agboola A. Pregnancy induced hypertension, preeclampsia and chronic hypertension. In: Agboola A (ed). Textbook of Obstetrics and Gynaecology for Medical Students, 2nd ed. Heinemann Educational Books (Nigeria) Plc. 2006;348-359.
Yakassai IA, Morhason-Bello IO. Risk factors for preeclampsia among women at antenatal booking in Kano, Northern Nigeria, Nigeria. Health Care in Low Resource Settings. 2013;(1). Available:https://www.pagepressjournals.org/index.php/his/article/ view/his.2013.e/12/5460