Effect of Serum Uric Acid Level on Outcome of Pregnancy in Pre-Eclampsia

Abstract

Introduction: Pre-eclampsia is considered as a major cause of maternal and fetal morbidity and mortality. When a pre-eclamptic women develops associated hyperuricemia, fetal outcome may become worse. Raised serum uric acid in pre-eclamptic mother affects maternal and fetal condition which in turn give rise to poor maternal and fetal outcome. Objective: To find out the effect of serum uric acid on outcome of pre eclamptic patient. Study design: It was analytic type of cross sectional study. Study setting and period: The study was done in Dhaka Medical College Hospital. The study period was March 2016 to September, 2016. Participants: Among all patients who fulfilled the inclusion criteria during the study period and who gave consent were selected. Methodology: The study was performed on 50 women with pre- eclampsia. The study was performed on two groups; the first group (n=25) with serum uric acid > 6 mg/dl (hyperuricemia group-A) was compared to the second group (n=25) with serum uric acid 6) was 27.8±7.0% and in normal uric acid group (uric acid-6) was 26.6±7.7%. There was no statistically significant differenc of Mean±SD of age between two groups. Most of the participants were primi. In hyperuricemic group, 15(60%) were primi and in normal uric acid group, 13(52%) were primi. Mean±SD of systolic blood pressure of both group had non-significant difference (p-0.760). Mean±SD of diastolic pressure was 114.40±115.57 mmHg in hyperuricemic group and 105.40±13.06 mmHg in normal uric acid group. The difference of diastolic pressure between two groups were significant (p-0.032). In hyperuricemic group, Mean±SD of uric acid was 7.66±1.59 mg/dl and Mean±SD of uric acid was 4.71±0.85 mg/dl in normal uric acid group. Mean±SD of Uric acid of both groups had significant difference (p-0.001). Termination was needed earlier in hyperuricemic group than normal uric acid group although Mean±SD of gestational weeks of both groups had non-significant difference (p-0.84). Hyperuricemic group had 7(28.0%) eclampsia, 1(4.0%) acute renal failure, 2(8.0%) HELLP, 2(8.0%) pulmonary edema and 3(12.0%) PPH but normal uric acid group had 2(8.3%) eclampsia, acute renal failure 0(0.0%), HELLP 0(0.0%), pulmonary edema 0(0%), PPH 0(0.0%). Mean±SD of maternal complications of both groups had significant difference (p-0.001). In hyperuricemic group, 5(20.8%) birth asphaxia, 7(29.2%) preterm baby, 6(25.0%) still birth, 2(8.3%) perinatal death. In normal uric acid group, 1(4.0%) birth asphaxia, 9(36.0%) preterm baby, 0(0.0%) still birth,0(0.0%) perinatal death. Mean±SD of fetal complications between two groups were statistically significant (p-0.003). Moreover, the complications either maternal or fetal was more in hyperuricemic group than normal uric acid group. Conclusion: As there are some limitation the result will not reflect cent percent of the real picture among Bangladeshi population. This study identifies association of hyperuricemia with maternal and fetal outcome in pre-eclamptic patients. Since this complications are preventable if detected and treated at an early stage, and to institute proper medical care in time. Development of simple, sensitive biochemical test is therefore important to detect pregnant women who are at a risk of developing pre- eclampsia.