scholarly journals Level of hsCRP Maternal Serum During Puerperium of Severe Preeclampsia

2018 ◽  
Vol 4 (1) ◽  
pp. 9
Author(s):  
Julian Dewantiningrum ◽  
Zaki Hetami

Background: Preeclampsia and eclampsia arestill major problemsin the world. Maternal mortality of severe preeclampsia at the puerperal period is likely to be greater because of the cardiovascular diseases (CVD). HsCRP (high sensitivity C-Reactive Protein) is a usefull prediction for CVD among non preeclamptic patients. Before using hsCRP as a marker for that prediction of cardiovascular event from preeclamptic patient, we should do research to know difference of hsCRP between preeclampsia and normal pregnancy.Objective: To determine the differences levels of hsCRP among severe preeclampsia and normal pregnancyMethod : A cross sectional study was conducted to severe preeclampsia. The inclusion criteria were subjects in puerperal period (2- 6 weeks) with a history of severe preeclampsia and normotensive.Exclusion criteria were puerperal infection, chronic hypertension, metabolic syndrome, caesarean section delivery and refuse to join this research. All subjects were examined the levels of hsCRP maternal serum when blood pressure £140 / 90.Result: Subjects were consist of 26 severe preeclampsia (53%) and 23 normal pregnancy (46.9%). Level of hsCRP in severe preeclampsia was 4.73 +3.57while in normotensive 2.42 +4.14 (p <0.05). Severe preeclampsia group will increase the risk of hsCRP rise as much as 2.5 times compared to the normotensive group.Conclusion:Level of hsCRP in patients with preeclampsia post partum were higher than patients with normal pregnancies. 

2020 ◽  
Vol 24 (3) ◽  
pp. 187-192
Author(s):  
Tabinda Khalid ◽  
Rubaba Abid Naqvi ◽  
Nisar Ahmed Malik ◽  
Hamna Sarwar

bjective: To determine the prevalence of raised ALT, common causes, and associated fetomaternal morbidity  in pregnant mothers presenting, at cantonment general hospital Rawalpindi Materials and Methods: This was a cross-sectional study conducted at cantonment general hospital Rawalpindi from July 2016 till June 2017. Results: Out of 1924 women, 102 were identified with raised ALT making a prevalence of 5.3%. Sixty-one (59.8%) were booked. The hypertensive group which included severe preeclampsia, chronic hypertension with superimposed preeclampsia/eclampsia were 55(53.9%), intrahepatic cholestasis of pregnancy(ICP) 32(31.7%), acute viral hepatitis 9(8.8%), Acute fatty liver of pregnancy(AFLP) 2(1.96%), and unknown cause in 4(3.92%). Mean ALT levels were 54.1±6.94, 71.28±23.25, 84.22±27.82, 231.5±47.37 respectively. In four cases no definitive cause could be identified with the available tests were labeled as an unknown group, having a mean ALT level of 79.25±10.07. (p=0.01). Term delivery occurred in 71(69.6%), while 31(30.39%) were preterm. There was one termination of pregnancy. Vaginal birth occurred in 42(42.2%), and 53(51.9%) underwent emergency cesarean. There was one peripartum hysterectomy. Meconium stain of liquor was 19(18.6%). The birth weight of most babies 73(71.5%) was between 2-3 kilograms only three were ≤ 1 kilograms. Eight cases of postpartum hemorrhage, three maternal deaths, and six perinatal/early neonatal deaths were observed. Conclusion: Raised ALT in pregnancy leads to increased fetomaternal complications. Severe preeclampsia and obstetric cholestasis were the commonest causes. Women of younger age groups were having acute viral hepatitis. Timely recognition and diagnosis are essential to institute appropriate management strategies.


2013 ◽  
Vol 131 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Rose Gasnier ◽  
Edimárlei Gonsales Valério ◽  
Janete Vettorazzi ◽  
Sérgio Hoffmeister Martins-Costa ◽  
Elvino Guardão Barros ◽  
...  

CONTEXT AND OBJECTIVE Sodium excretion abnormalities in preeclampsia have been studied in relation to several factors. The objective of this study was to compare natriuria (mEq/24 h) and calciuria levels (mg/24 h) in preeclamptic patients. DESIGN AND SETTING An analytical cross-sectional study with a control group was conducted in the obstetric center and the high-risk pregnancy outpatient clinic at a university hospital in southern Brazil, and in a primary healthcare unit in the same city, including pregnant women with mild preeclampsia, severe preeclampsia or chronic hypertension, and women with normal pregnancies (14 patients in each group). METHOD Natriuria was measured using an ion-selective electrode in an automated clinical chemistry analyzer (Hitache 917, Roche). All the patients collected 24-hour urine, at home or at the hospital, for analysis of proteins, creatinine, calcium, sodium and uric acid. Quantitative variables with asymmetrical distribution were described using the median, minimum and maximum, and were compared using the Kruskal-Wallis test. The results were logarithmically transformed, with one-way analysis of variance (ANOVA) by ranks and then the post-hoc Tukey test, and were analyzed by means of the Spearman correlation and receiver operating characteristic (ROC) curve. The significance level used was 0.05. RESULTS There were significant differences between the groups in comparing severe preeclampsia with chronic hypertension and severe preeclampsia with controls (P < 0.0001 for both measurements). CONCLUSION Natriuria levels may be lower in preeclampsia when associated with calciuria. Natriuria assessment is an additional test for differential diagnosis of hypertensive diseases in pregnancy, but is a poor predictor when used alone.


2019 ◽  
Vol 1 (1) ◽  
pp. 22-29
Author(s):  
Joserizal Serudji ◽  
Helga Helga ◽  
Hafni Bachtiar

The high incidence of preeclampsia and eclampsia causes the importance of early detection especially eclampsia which is the main cause of maternal morbidity and mortality and bad perinatal outcome. The etiology was unknown, but is related to changes in electrolyte status. Electrolytes such as calcium (Ca2+), Magnesium (Mg2+), sodium (Na+) and potassium (K+) play an important role in pre-eclampsia and eclampsia because they contribute significantly in vascular smooth muscle function. This study was done to analyze the differences in mean levels of calcium magnesium ratio and sodium potassium ratio of maternal serum in severe preeclampsia and eclampsia. We performed an observasional comparative with cross sectional study on 16 women with severe preeclampsia and 16 women with eclampsia who met the inclusion criteria and there were no exclusion criteria. The samples were recruited in Dr. M Djamil general hospital Padang, Solok District Hospital, and Pariaman District Hospital from May 2015 to January 2016. The levels of calcium serum were examined by atomic absorption spectrophotometry (AAS), magnesium levels were examined by enzymatic metode, sodium and potassium levels were examined by ion selection electrode (ISE). The differences in mean levels of calcium magnesium ratio and sodium potassium ratio between the two groups was analyzed by using independent t test. The mean levels of calcium magnesium ratio in severe preeclampsia was significantly higher than eclampsia. The mean levels of sodium potassium ratio in severe preeclampsia was significantly lower than eclampsia.Keywords: Calcium magnesium ratio, sodium potassium ratio, severe preeclampsia, eclampsia


2019 ◽  
Vol 3 (1) ◽  
pp. 27-36
Author(s):  
Yogi Syofyan ◽  
Joserizal Serudji ◽  
Hafni Bachtiar

There will be multiple organs changes in preeclampsia and eclampsia. One of them is a change in hemostasis system which is platelet activation, extrinsic and intrinsic cascade reaction and increasing of fibrinolytic activation. This is a cross sectional study conducted at Obstetric and Gynecologic Departement of Medical Faculty of Andalas University/ M Djamil Central Hospital in Padang on July 2014 with the number of samples are 44 persons. Samples are divided into 3 groups: Severe preeclampsia, eclampsia, and normal pregnancy. Platelet, PT,APTT, and D-Dimer counting were conducted and statistic analyzed was done with Anova dan Post Hoc Bonferoni. The more severe pregnancy, the lower platelet count and PT, but the dif- ference is not statistically significant between three groups: severe preeclampsia, eclampsia, and normal pregnancy (p < 0,05). Mean of APTT and D-Dimer is statistically significant due to condition of pregnancy. Post Hoc Bonferroni analysis showed a significant difference of APTT mean in the eclampsia, severe pre-eclampsia, and normal pregnancy (p <0,05 ). D-Dimer Mean shows a significant difference between normal pregnancy, severe preeclampsia, and eclampsia (p <0,05).Keywords: Pregnancy condition, severe preeclampsia, eclampsia, normal pregnancy, platelet, PT, APTT, and D-Dimer


Author(s):  
Noroyono Wibowo ◽  
Fitriana Fitriana

Objective: to compare zinc, selenium, iron and copper levels in maternal serum of normal and preterm pregnancy. Methods: It is a cross sectional study with preterm and normal pregnant woman who will carry delivery in Dr. Cipto Mangunkusumo National Hospital and Budi Kemuliaan Hospital Jakarta from January to April 2017. This study was conducted by comparing the levels of each micronutrient in both groups of subjects. Result: From January until April 2017, there were 53 subjects divided into 30 normal pregnant women and 23 preterm pregnant women. The levels of zinc, selenium iron and copper in preterm pregnancy were 42 µg/dL, 72,39 µg/L, 74 µg/L, and 2144,52 µg/dL. Levels of zinc, selenium, iron and copper in normal pregnancy were 42 µg/dL, 67,27 µg/L, 70,5 µg/L, and 2221 µg/dL. There was no difference in micronutrients level in both groups. Conclusion: This study concluded that there was no difference in zinc, selenium, iron and copper levels in normal and preterm pregnancy. Keywords: pregnancy, zinc, selenium, iron, copper   LatarBelakang:Persalinan preterm adalahpersalinansebelumusiakehamilan 37 minggulengkap. Persalinan preterm inimasihmenjadimasalah di seluruhdunia.Padalaporan World Health Organization (WHO), Indonesia mendudukiperingkatkelimanegaradenganpersalinan preterm terbanyakyakni 675.700 persalinanpadatahun 2010.Berbagaifaktordihubungkandenganpenyebabterjadinyapersalinan preterm, termasuksalahsatunyaadalahgangguannutrisiselamakehamilan, terutamaseng, selenium, besidantembaga. Tujuan:Penelitianinimembandingkankadarseng, selenium, besidantembagapada serum maternal ibuhamil normal dan preterm. Metode:Penelitiandilakukandenganujipotong-lintangdengansubjekpenelitianibuhamilbaik preterm maupunaterm yang akanmelaksanakanpersalinan di RSUPN Dr. CiptoMangunkusumodan RS Budi Kemuliaan Jakarta padaJanuarihingga April 2017. Penelitiandilakukandenganmembandingkankadarmasing-masingmikronutrienpadakeduakelompoksubjek. Hasil:DalamjangkawaktuJanuarihingga April 2017 didapatkan 53 subjekpenelitianyakni 30 ibuhamil normal dan 23 ibudengankehamilan preterm. Seluruhsubjekdimasukkandalamanalisis data.Kadar seng, selenium, besidantembagapadaibudengankehamilan preterm secaraberurutanadalah 42 µg/dL, 72,39 µg/L, 74 µg/L, dan 2144,52 µg/dL.Sedangkankadarseng, selenium, besidantembagapadaibuhamil normal secaraberurutanadalah 42 µg/dL, 67,27 µg/L, 70,5 µg/L, dan 2221 µg/dL. Tidakadaperbedaanbermaknakadarmikronutrienpadakeduakelompoksubjek. Kesimpulan: Penelitianinimenyimpulkanbahwatidakadaperbedaankadarseng, selenium, besidantembagapadaibuhamil normal danibudengankehamilan preterm. Kata kunci:kehamilan, seng, selenium, besi, tembaga


2016 ◽  
Vol 51 (4) ◽  
pp. 272
Author(s):  
Warih Angesti P ◽  
Ernawati Ernawati ◽  
Dwi Susanti

Hemolysis, elevated liver enzyme, and low platelet count syndrome (HELLPs) is complication following severe preeclampsia which is one of the three leading causes of maternal mortality in Indonesia. The purpose of this study was to understand the prevalence, characteristics, and post-partum outcome of HELLPs patients who deliver in Dr. Soetomo Hospital in July 2012-June 2013. This study was observational-descriptive, cross sectional study. The population observed was the severe preeclampsia patients who deliver in Dr. Soetomo Hospital and have complete medical data in July 2012-June 2013. study subject taken by total sampling. HELLPs follow the 7% of severe preeclampsia patients. The maternal average age of HELLPs group was 30.2 (19-43), while in non-HELLPs was 30.8 (17-46). Most HELLPs patients were in the first and second pregnancy. The average of gestational age at labor in HELLPs was 33-34 weeks. Both in HELLPs and non-HELLPs most performed Cesarean Section delivery. No post-partum maternal mortality found in HELLPs, but 25% had stillbirth. The average of birth weight in HELLPs was 1994.4 g. First minute Apgar score >7 was 33.3% in HELLPs group. In conclusion, Most HELLPs patients were in the first and second pregnancy, while non-HELLPs were in first pregnancy. The average of gestational age at labor was lower in HELLPs group. Neonates mortality were higher in HELLPs group. The average of birth weight was lower in HELLPs group. First minute Apgar score > 7 was higher in non-HELLP group.


Author(s):  
Feriha Fatima Khidri ◽  
Hina Riaz ◽  
Farah Naz ◽  
. Almas ◽  
Arsalan Ahmed Uqaili ◽  
...  

Objectives: To determine the serum calcium levels in mild and severe preeclampsia and compare it with normal pregnancy. Methods: It was a comparative cross sectional study. Thirty five normotensive pregnant women, n=30 women with mild preeclampsia and n=70 with severe preeclampsia were recruited at Liaquat University of Medical and Health Sciences, Hospital. The serum calcium was measured and levels were compared among three groups. The data was analysed on SPSS v. 20. Results: The gestational age was more in the normal pregnancy compared to mild and severe preeclampsia (38.7±2.1 vs 36.7±3.6 and 36.2±2.8, p-value=0.0002). The calcium concentration was less in the both groups of preeclampsia i.e., 8.41± 0.96 mg/dl in mild and 8.02± 0.77 mg/dl in severe preeclampsia vs 9.2± 0.32 mg/dl in normal pregnant women, (p-value <0.001). Conclusion: We found lower levels of serum calcium in preeclampsia, suggesting its possible role in pathogenesis. Further studies to investigate the potential role of dietary supplementation of micronutrients during pregnancy are recommended.


Author(s):  
Kurnia M. Isasari ◽  
Wim T Pangemanan ◽  
Iskandar Zulqarnain ◽  
Kemas Rahadiyanto

Objective: To determine the comparison between maternal cystatin C serum in severe preeclampsia and normal pregnancy. Method: This was an observational study with cross sectional analytic approach. The subjects are sixty women with severe preeclampsia and normal pregnancy who met inclusion criteria. The maternal serum level of cystatin C was automatically measured with Particle Enhanced Nephelometric Assay (PENIA). Result: Mean serum level of cystatin C in severe preeclampsia was 1.169 ± 0.311 mg/l. Mean serum level of cystatin C in normal pregnancy was 0.929 ± 0.166. There was a significant differences between maternal serum levels of cystatin C in women with severe preeclampsia compared with women with normal pregnancy. Conclusion: There was a significant differences between maternal serum levels of cystatin C in severe preeclampsia compared with normal pregnancy. Keywords: cystatin C, endotheliosis glomerulus, severe preeclamp


Author(s):  
Meice Fitrina ◽  
Sofie R. Krisnadi ◽  
Hartanto Bayuaji

Abstract Objective: To determine differences in serum nephrin levels in severe preeclampsia compared to normal pregnancy and also its correlation with systolic and diastolic blood pressure and proteinuria.Methods: This study is an analytical observational with cross sectional study. The observation group consisted of severe preeclampsia (n= 30) and normal pregnancy group as a control (n= 30). Both groups measured systolic and diastolic blood pressure, proteinuria and serum nephrin using the Human NPHN (Nephrin) ELISA Kit. Statistical test were performed with Mann-Whitney test and the Spearman’s rank test. A value of p<0.05 was considered significant. The study was conducted in the Obstetric Clinic Inward and Laboratorium Department of Clinical Pathology Dr. Hasan Sadikin General Hospital/Faculty of Medicine Universitas Padjadjaran on March–May 2019.Results: Levels of serum nephrin in the severe preeclampsia group were significantly higher than in normal pregnancies (6.4 ng/mL vs 4.2 ng/mL; p= 0.014). There is a positive weak correlation but statistically significant between serum nephrin with systolic blood pressure (r= 0.36; p= 0.02) but not significant to diastolic blood pressure (r= 0.3; p= 0.05). There is no significant correlation was found between serum nephrin levels and proteinuria (r= 0.18; p= 0.54).Conlusions:  Levels of serum nephrin in the severe preeclampsia group were significantly higher than in normal pregnancies and there is a correlation between serum nephrin with systolic blood pressure. Keywords: blood pressure, proteinuria, serum nephrin, podocyte, severe preeclampsia. Abstrak Tujuan: Untuk mengetahui perbedaan kadar nephrin serum pada preeklamsia berat dibandingkan dengan kehamilan normal dan juga hubungannya dengan tekanan darah sistolik dan diastolik serta proteinuria.Metode: Penelitian ini bersifat analitik observasional dengan pendekatan potong silang. Kelompok pengamatan terdiri dari kelompok preeklamsia berat (n= 30) dan kelompok kehamilan normal sebagai kontrol (n= 30). Pada kedua kelompok dilakukan pengukuran tekanan darah sistolik dan diastolik, proteinuria serta pengukuran kadar nephrin serum menggunakan Human NPHN (Nephrin) ELISA Kit. Uji statistik dilakukan dengan uji Mann-Whitney dan uji rank Spearman. Nilai p<0,05 dianggap bermakna. Penelitian dilakukan di ruang perawatan obstetri FKUP/RSHS dan Laboratorium Patologi Klinik FKUP/RSHS pada bulan Maret-Mei 2019.Hasil: Rerata kadar nephrin serum pada kelompok preeklamsia berat lebih tinggi secara bermakna dibandingkan kehamilan normal (6,4 ng/mL vs 4,2 ng/mL; p= 0,014). Terdapat korelasi positif dengan derajat lemah namun bermakna secara statistik antara nephrin serum dengan tekanan darah sistolik (r= 0,36; p= 0,02) namun tidak signifikan terhadap tekanan darah diastolik (r= 0,3; p= 0,05). Tidak ditemukan korelasi yang bermakna antara kadar nephrin serum dengan proteinuria (r= 0,18; p= 0,54). Kesimpulan: Kadar nephrin serum pada kelompok preeklamsia berat lebih tinggi dibandingkan kehamilan normal dan terdapat korelasi antara nephrin serum dengan tekanan darah sistolik. Kata kunci: nephrin serum, podosit, preeklamsia berat, proteinuria, tekanan darah


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rima Irwinda ◽  
Rabbania Hiksas ◽  
Aprilia Asthasari Siregar ◽  
Yudianto Budi Saroyo ◽  
Noroyono Wibowo

AbstractLong-Chain Polyunsaturated Fatty Acid (LCPUFA) is essential throughout pregnancy, since deficiency of LPUFA may linked to obstetrical complications. This study aimed to investigate LCPUFA status in severe preeclampsia and preterm birth. A cross sectional study was conducted in 104 pregnant women, which divided into normal pregnancy, severe preeclampsia and preterm birth groups. Serum percentage and concentration of total LCPUFA, omega-3, alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), omega-6, linoleic acid (LA), and arachidonic acid (AA) were measured using gas chromatography/mass spectrometry. Receiver operating characteristic (ROC), bivariate and multivariate analysis were performed. Severe preeclampsia showed the highest concentration of total PUFA and the lowest DHA percentage, with significantly higher Omega-6/Omega-3 ratio (p = 0.004) and lower omega-3 index (p < 0.002) compared to control. Preterm birth showed the least omega-3 concentrations, with significantly low omega-6 derivates (LA (p = 0.014) and AA (p = 0.025)) compared to control. LCPUFA parameters have shown to increase the risk in both conditions, particularly ALA ≤ 53 µmol/L in preeclampsia with OR 5.44, 95%CI 1.16–25.42 and preterm birth with OR 4.68, 95%CI 1.52–14.38. These findings suggest that severe preeclampsia and preterm birth have an imbalance in LCPUFA status.


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