scholarly journals Effects of hyperuricemia on perinatal outcome in hypertensive disorder of pregnancy

2009 ◽  
Vol 4 (2) ◽  
pp. 36-40
Author(s):  
Asma Ul Hosna ◽  
AKM Mohiuddin Bhuiyan ◽  
Noor E-Ferdous ◽  
Md Khurshed Ahmed ◽  
Md Abu Siddique ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Acid Group ◽  
Maternal Blood ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Preterm Baby ◽  
Group A ◽  
Hypertensive Disorder Of Pregnancy ◽  
In Pregnancy

The purpose of this study was to detect elevated uric acid level in maternal blood, presumably due to decrease renal urate excretion, for early detection of hypertensive disorder in pregnancy. This study showed that serum uric acid was significantly elevated in all cases of preeclampsia. The present study showed that serum uric acid levels were significantly elevated in eclampsia as compared with the levels in pregnancies complicated by hypertension (p < 0.05). The level of uric acid above 4.5 mg/dl is indicative of preeclamptic process and in such cases; the subjects deserve careful and close clinical follow up. Increasing higher concentration of uric acid i.e. 5.7 mg/dl, 6.3mg/dl, and 6.72mg/dl was observed in pregnancy with chronic hypertension, preeclampsia and eclampsia respectively. These results showed that serum uric acid could be used as a sensitive indicator of severity of preeclampsia. Out of 100 cases, there were 20 preterm baby and others such as stillbirth and IUD. So, these entire abnormal fetal outcomes were in the hyperuricaemic group and 5.37 times higher as compared to low serum uric acid group. Mean birth weight of preeclampsia and eclampsia were 2.31kg and 2.30kg respectively compared with 2.5kg in chronic hypertension group.    doi:10.3329/uhj.v4i2.2074 University Heart Journal Vol. 4 No. 2 July 2008 p.36-40

scholarly journals Maternal Serum Uric Acid as a Predictor of Severity of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

2019 ◽  
Vol 15 (2) ◽  
pp. 154-160
Author(s):  
Naina Kumar ◽  
Amit K. Singh
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternal Serum ◽  
Hypertensive Disorder ◽  
Hypertensive Disorders Of Pregnancy ◽  
Tertiary Care Centre ◽  
Hypertensive Disorder Of Pregnancy

Objective: To assess the relationship between maternal serum uric acid and severity of Hypertensive disorders of pregnancy in a rural tertiary care centre. Materials and Methods: Present study was conducted in Obstetrics and Gynaecology department of rural tertiary care centre of Northern India over seven months (October 2016-May 2017) on 110 women admitted with a Hypertensive disorder of pregnancy (Gestational hypertension, Preeclampsia, Eclampsia) at ≥;34 weeks gestation. Maternal serum uric acid levels were compared in three groups in relation to disease severity, mode of delivery, maternal outcome. Results: Of total 110 women with a Hypertensive disorder of pregnancy; 35 (31.81%) had Gestational Hypertension, 49 (44.54%) preeclampsia and 26 (23.63%) had eclampsia. Mean±SD values for serum uric acid were 5.47±1.93 mg/dl in women with Gestational Hypertension; 6.72±2.15 mg/dl in Pre-eclampsia and 8.71±2.97 mg/dl in the eclamptic group. Of 110 women 34(97.14%) with gestational hypertension, 27(55.10%) with pre-eclampsia and one (3.85%) with eclampsia remained stable in post-partum period, 17 (34.69%) women with severe pre-eclampsia and 15 (57.69%) with eclampsia required intensive care in postpartum period and one (2.86%) women with gestational hypertension, five (10.20%) with pre-eclmapsia and ten (38.46%) with eclampsia required ventilator support and high dependency unit care. Of these 16 women with the severe disease, ten succumbed to death. Also, in women with serum uric acid,>6mg/dl, most common mode of delivery was a lower segment cesarean section (50.90%). Conclusion: Significant correlation was observed between maternal serum uric acid, disease severity and maternal outcome.

scholarly journals A Significant Increase in Maternal Blood Uric Acid Levels Accompanies the Severity of Hypertensive Disorders in Pregnancy

2021 ◽  
pp. 144-148
Author(s):  
Yuyun Lisnawati ◽  
Jimmy Sakti ◽  
Rima Irwinda ◽  
Kindy Agustin ◽  
Nadia Nurfauziah
Keyword(s):  
Uric Acid ◽  
Birth Weight ◽  
Serum Uric Acid ◽  
Apgar Score ◽  
Maternal Blood ◽  
Hypertensive Disorders ◽  
Blood Uric Acid ◽  
Hypertensive Disorders In Pregnancy ◽  
Minute Apgar Score ◽  
In Pregnancy

Objective: To asses the relationship between maternal serum uric acid level and severity of hypertensive disorders in pregnancy and perinatal outcomes.Methods: A cross sectional study was conducted at Persahabatan Hospital from January 2014 to December 2018. Subject were pregnant women with hypertensive disorder. Serum uric acid levels were taken from a venous blood sample at the time the patient came for delivery. The severity of hypertensive disorders in pregnancy were grouped into chronic hypertension, gestational hypertension, preeclampsia without severe feature, preeclampsia with severe feature, and preeclampsia with severe feature and organ involvement. The perinatal outcomes were the gestational age at birth, birth weight, and the first minute APGAR score. The relationship between maternal serum uric acid level and severity of hypertensive disorders in pregnancy and perinatal outcomes were analyzed using Mann Whitney and Kruskall Wallis test.Result: A total of 704 out of 880 pregnant women with hypertensive disorder have met the criteria as research subjects. Maternal uric acid levels were found to increase significantly (p <0.001) with increasing severity of hypertensive disorders in pregnancy. Maternal who experienced preterm delivery had significantly higher blood uric acid levels (p <0.001) than those who experienced a term delivery. Maternal blood uric acid levels of infants with small birth weight for gestational age and first minute Apgar score <7 were slightly higher but not significant compared to maternal blood uric acid levels of normal birth weight infants and first minute Apgar score >7.Conclusions: Maternal blood uric acid levels increased significantly accompanying the severity of hypertensive disorders in pregnancy. Blood uric acid levels tend to be higher in maternal who have poor perinatal outcomes.Keywords: APGAR score, hypertensive disorders in pregnancy, preeclampsia, uric acid. AbstrakTujuan: Untuk menilai hubungan antara kadar asam urat serum ibu dan keparahan gangguan hipertensi pada kehamilan dan luaran perinatal.Metode: Studi potong lintang dilakukan Rumah Sakit Persahabatan periode Januari 2014 sampai Desember 2018. Subjek penelitian adalah ibu hamil dengan gangguan hipertensi. Kadar asam urat darah diambil dari sampel darah vena pada saat ibu hamil datang untuk melahirkan. Tingkat keparahan gangguan hipertensi pada kehamilan dikelompokkan menjadi hipertensi kronik, hipertensi gestasional, preeklamsia tanpa gejala berat, preeklamsia dengan gejaka berat, dan preeklamsia dengan gejala berat dan keterlibatan organ. Luaran perinatal adalah usia kehamilan saat lahir, berat badan bayi lahir, dan skor APGAR menit pertama. Hubungan antara kadar asam urat darah ibu dan tingkat keparahan gangguan hipertensi pada kehamilan dan luaran perinatal dianalisis menggunakan uji Mann Whitney atau uji Kruskall Wallis.Hasil: Sebanyak 704 dari 880 ibu hamil penderita hipertensi telah memenuhi kriteria sebagai subjek penelitian. Kadar asam urat darah ibu meningkat secara signifikan (p <0,001) dengan meningkatnya keparahan gangguan hipertensi pada kehamilan. Ibu yang melahirkan preterm memiliki kadar asam urat darah yang lebih tinggi secara bermakna (p < 0,001) dibandingkan ibu yang melahirkan aterm. Kadar asam urat darah ibu dari bayi dengan berat lahir kecil untuk usia kehamilan dan skor Apgar menit pertama < 7, sedikit lebih tinggi tetapi tidak signifikan, dibandingkan kadar asam urat darah ibu dari bayi berat lahir normal dan skor Apgar menit pertama pertama > 7.Kesimpulan: Kadar asam urat darah ibu meningkat secara signifikan menyertai beratnya gangguan hipertensi pada kehamilan. Kadar asam urat darah cenderung lebih tinggi pada ibu yang memiliki luaran perinatal kurang baik.Kata kunci: APGAR, asam urat, hipertensi dalam kehamilan, preeklamsia.

scholarly journals Uric Acid as a biomarker for hypertensive disorder of pregnancy:

2018 ◽  
Vol 27 (1) ◽  
pp. 24-28
Author(s):  
Hasina Akhter ◽  
Farah Deeba ◽  
SMA Taher ◽  
Shipra Chaudhury ◽  
Nazmun Nahar ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Uric Acid Level ◽  
Acid Level ◽  
Serum Uric Acid Level ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Individual Values ◽  
Increased Risk ◽  
Experimental Group

Maternal, fetal complications are correlated with hypertensive disorders during pregnancy. In this context, maternal blood uric acid level is reported to be one of the prognostic factors in determining the perinatal out come. The purpose of the present study is to estimate serum uric acid levels in preeclamptic, eclamptic and normotensive groups to identify woman who are at high risk of developing the disease early in pregnancy. The study may provide possible biochemical parameter in preeclampsia and eclamsia. This is because early identification of biochemical markers of the disease would not only facilitate to identify those at increased risk for pre eclampsia but also help to determine those patients likely to benefit from interventional measures. A total 50 patients were selected and categorized into three groups. 30 among 50 woman, were pregnancy induced hypertension BP>140/90 mm Hg. Who were as the experimental group and remaining 20 were normotensive (BP <140/90 mm Hg) taken as control (n=20). The experimental group was further categorized into two groups having 20 woman in preeclampsia (n=20), and Ten in eclampsia (n=10). The serum uric acid level studied in various study group showed a significant in pre eclampsia (n=20) and the eclamptic(n=10). The serum uric acid level for women with pre eclamsia 5 mg/dl-6.3 mg/dl n-10) were significant higher than those of controls (4-56 mg/dl n=20) more ever, it was experimentally found that the individual values of observed serum uric acid in preeclamptics and eclamptic were relatively higher than those of the average values of normotensive. In the setting of chronic hypertension, however a serum uric acid level at> or =5.5 mg/dl could identify women with increased likelihood of having superimposed pre eclampsia. A comparison between three groups related that hyperuricemia in patient with preeclampsia,eclampsia is certainly a risk factor for several perinal and maternal complications.TAJ 2014; 27(1): 24-28

MO427SAFE USE OF ALLOPURINOL TO TREAT ACUTE URIC ACID NEPHROPATHY IN PREGNANCY: A CASE REPORT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Fahd Khan ◽  
Aizaz Ali ◽  
Jamie Willows ◽  
Didem Tez
Keyword(s):  
Uric Acid ◽  
Case Report ◽  
Serum Creatinine ◽  
Serum Uric Acid ◽  
Renal Tubules ◽  
Normal Range ◽  
History Of ◽  
Uric Acid Nephropathy ◽  
Acute Uric Acid Nephropathy ◽  
In Pregnancy

Abstract Introduction Acute uric acid nephropathy (UAN) is characterized by acute kidney injury (AKI) due to uric acid crystal precipitation within the distal tubules and collecting ducts. We present a young woman, with a history of hyperuricaemia, who was treated with allopurinol for acute UAN during her first pregnancy. She also continued allopurinol treatment during her second pregnancy for prevention of further acute UAN. To the author’s knowledge, this is the first case report of biopsy-confirmed acute UAN during pregnancy. Case report A 20 year old woman, who was 13 weeks pregnant, was admitted with AKI. Past medical history included chronic kidney disease (CKD) and gout since the age of 17. She had an extensive family history of CKD and gout (without diagnosis, despite genetic testing). She had been on daily allopurinol 300mg, but this was stopped 8 weeks prior by her rheumatology team due to concerns about teratogenicity. At that time serum creatinine was at her baseline of 100 μmol/L (normal range 50-120 μmol/L) and serum uric acid had been 740 μmol/L (normal range 140-360 μmol/L). On admission, she felt well and was euvolemic. Serum creatinine was now 352 μmol/L and her serum uric acid level was 1720 μmol/L, with an elevated urine uric acid to creatinine ratio of 1.1. She underwent renal biopsy, which showed significant deposition of uric acid crystals in the renal tubules, confirming a diagnosis of acute UAN. She was given intravenous fluids. The uncertainties of allopurinol use in pregnancy were discussed with her, and she was restarted on allopurinol 200 mg daily. Over the next 3 weeks, serum uric acid decreased to 470 μmol/L and serum creatinine to 116 μmol/L. She was maintained on allopurinol during her pregnancy and delivered a healthy baby girl. She was advised against further pregnancies due to increased risk of maternal and fetal complications. However, three years later she presented at 15 weeks’ gestation. After a discussion regarding the potential teratogenic effects of allopurinol versus the risk of recurrent severe AKI due to acute UAN if it was again discontinued, she chose to continue allopurinol. The pregnancy proceeded without complication. Her daughters are now 8 and 5 years old. They do not have any congenital malformations, though both have mild to moderate learning difficulties. Discussion Allopurinol is approved for the treatment of hyperuricaemia outside of pregnancy, but given it interrupts purine synthesis there is a biologically plausible concern regarding teratogenicity. However, in our patient with long-standing hyperuricaemia it was the discontinuation of allopurinol that precipitated AKI due to the resultant crystal formation when serum uric acid reached very high levels. Biopsy confirmation of acute UAN was vital in this case, given the possibility of missing an alternative diagnosis and the risks of giving empirical allopurinol therapy. Once the diagnosis for her severe AKI was confirmed, it was clear our patient would benefit from uric acid lowering therapy. Our patient had two healthy girls despite using allopurinol from week 16 in her first pregnancy and throughout her second pregnancy. Unfortunately, both girls have mild to moderate learning needs, though it is unprovable whether allopurinol was causative as no study has followed up long term outcomes after foetal exposure during pregnancy.

Adverse Perinatal Outcomes Associated with Stage 1 Hypertension in Pregnancy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Elizabeth Norton ◽  
Frances Shofer ◽  
Hannah Schwartz ◽  
Lorraine Dugoff
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Outcomes ◽  
Hypertensive Disorder ◽  
Hypertension In Pregnancy ◽  
Increased Risk ◽  
Hypertensive Disorder Of Pregnancy ◽  
Adverse Perinatal Outcomes ◽  
Stage 1 ◽  
In Pregnancy

Objective To determine if women who newly met criteria for stage 1 hypertension in early pregnancy were at increased risk for adverse perinatal outcomes compared with normotensive women. Study Design We conducted a retrospective cohort study of women who had prenatal care at a single institution and subsequently delivered a live infant between December 2017 and August 2019. Women with a singleton gestation who had at least two prenatal visits prior to 20 weeks of gestation were included. We excluded women with known chronic hypertension or other major maternal illness. Two groups were identified: (1) women newly diagnosed with stage 1 hypertension before 20 weeks of gestation (blood pressure [BP] 130–139/80–89 on at least two occasions) and (2) women with no known history of hypertension and normal BP (<130/80 mm Hg) before 20 weeks of gestation. The primary outcome was any hypertensive disorder of pregnancy; secondary outcomes were indicated preterm birth and small for gestational age. Generalized linear models were used to compare risk of adverse outcomes between the groups. Results Of the 1,630 women included in the analysis, 1,443 women were normotensive prior to 20 weeks of gestation and 187 women (11.5%) identified with stage 1 hypertension. Women with stage 1 hypertension were at significantly increased risk for any hypertensive disorder of pregnancy (adjusted risk ratio [aRR]: 1.86, 95% confidence interval [CI]: 1.12–3.04) and indicated preterm birth (aRR: 1.83, 95% CI: 1.12–3.02). Black women and obese women with stage 1 hypertension were at increased for hypertensive disorder of pregnancy compared with white women and nonobese women, respectively (aRR: 1.32, 95% CI: 1.11–1.57; aRR: 1.69, 95% CI: 1.39–2.06). Conclusion These results provide insight about the prevalence of stage 1 hypertension and inform future guidelines for diagnosis and management of hypertension in pregnancy. Future research is needed to assess potential interventions to mitigate risk. Key Points

Maternal serum uric acid levels in pregnancy and fetal growth

2018 ◽  
Vol 33 (1) ◽  
pp. 24-32
Author(s):  
Guoli Zhou ◽  
Claudia Holzman ◽  
Zhehui Luo ◽  
Claire Margerison
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Fetal Growth ◽  
Maternal Serum ◽  
In Pregnancy

CLINICAL CHARACTERISTICS AND FETO-MATERNAL OUTCOMES IN PREGNANT WOMEN WITH COVID -19 INFECTIONS

2021 ◽  
pp. 30-32
Author(s):  
Gulshan Bano ◽  
Anubha Prashad ◽  
Rakhee Soni ◽  
Mohammed Mishal
Keyword(s):  
Pregnant Women ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Maternal Outcomes ◽  
Hypertensive Disorder ◽  
Co Morbidity ◽  
Hypertensive Disorder Of Pregnancy ◽  
The Mean ◽  
In Pregnancy

Background and objectives:-COVID-19 is ongoing pandemic, caused by novel Corona Virus. There is very scarce information is available about clinical features and feto-maternal outcomes of COVID-19 in pregnancy. Therefore, this study was aimed to determine clinical characteristics and feto-maternal outcomes of pregnant women with COVID-19. Methods- In this retrospective study, we included all pregnant women admitted with COVID-19 over three months. Clinical features, laboratory ndings and feto-maternal outcomes were assessed.Results:-The mean age of the patients was 24 years. Hypertensive disorder of pregnancy was most common associated co-morbidity. Majority of patients (81%) were asymptomatic. Lymphocytopenia was seen in 58% of the patients and 47% had elevated levels of CRP. All patients who presented in rst trimester had spontaneous abortion. There is relatively higher rate of preterm birth (21%) and cesarean delivery(43%). All the neonates were tested negative for COVID-19. Conclusion;- There is relatively higher rate of cesarean delivery. Overall feto-maternal outcome was good and there was no evidence of vertical transmission.

Natural killer cells and T lymphocytes in pregnancy and pre-eclampsia

2017 ◽  
Vol 131 (24) ◽  
pp. 2911-2917 ◽  
Author(s):  
Erin B. Taylor ◽  
Jennifer M. Sasser
Keyword(s):  
Natural Killer ◽  
T Lymphocyte ◽  
Immune Cells ◽  
Experimental Models ◽  
Innate Immune ◽  
Hypertensive Disorder ◽  
Hypertensive Disorder Of Pregnancy ◽  
Lymphocyte Populations ◽  
In Pregnancy

Although pre-eclampsia (PE), a hypertensive disorder of pregnancy, has significant maternal and fetal morbidity and mortality worldwide, the mechanisms contributing to this disease have not been fully elucidated. Studies in patients and experimental models have shown that changes in the number or function of immune cells of both the adaptive and innate immune systems contribute to the development and pathogenesis of PE. This commentary summarizes our current understanding of the role of the immune system in the pathogenesis of PE, specifically focussing on dysfunction of natural killer (NK) cells and T lymphocyte populations.

scholarly journals Assessing the Role of Uric Acid as a Predictor of Preeclampsia

2022 ◽  
Vol 12 ◽  
Author(s):  
Ana I. Corominas ◽  
Yollyseth Medina ◽  
Silvia Balconi ◽  
Roberto Casale ◽  
Mariana Farina ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Predictive Value ◽  
Gestational Hypertension ◽  
Low Cost ◽  
High Sensitivity ◽  
Use Of Resources ◽  
Before And After ◽  
High Negative Predictive Value ◽  
Group A

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 and D), uric acid increased after the 30th week of gestation. In all groups, UAr was greater than 1.5. In gestational hypertension, UAr was superior to 1.5 toward the end of gestation, while in IUGR without preeclampsia, the behavior of serum uric acid was similar to non-complicated pregnancies. In all cases, urea and creatinine showed normal values, confirming that patients had no renal compromise. ROC area was 0.918 [95% confidence interval (CI): 0.858–0.979) for the preeclampsia group and 0.955 (95% CI: 0.908–1.000) for Group A. UAr at a cut-off point ≥1.5 had a very low positive predictive value, but a high negative predictive value of 99.5% for preeclampsia and it reached 100% for Group A. Thus, a UAr less than 1.5 may be a helpful parameter with a strong exclusion value and high sensitivity for those women who are not expected to develop preeclampsia. Additionally, this low-cost test would allow for better use of resources in developing countries.

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