Association of Hypoproteinemia in Preeclampsia with Maternal and Perinatal Outcomes : A Prospective Analysis of High-Risk Women

Background: Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks gestation and can present as late as 4-6 weeks post-partum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema.Aim: The aim of the present study is to evaluate and assess the maternal and perinatal outcomes in preeclampsia (PE), according to serum albumin value.Materials and Methods: In this study, 50 preeclamptic patients were divided into two groups according to the serum albumin level. To date, there has been no widely accepted predictive test or therapeutic intervention to prevent or delay preeclampsia. Patients included in the study were divided into two groups : group A preeclampsia with an albumin value of > 25g/l (mild hypoproteinemia). Group b preeclampsia with an albumin value of < 25 g/l (severe hypoproteinemia). All the cases were subjected to full obstetric assessment and routine laboratory investigations including serum albumin value.Results: Severe hypoproteinemia has higher incidence of cesarean section delivery mode than mild hypoprteinemia. Severe hypopreteinemia has a higher percentage and risk of preterm labor than mild hypoprotenimia. Liver function and renal function tests are affected mainly with higher percentage in SHP than MHP. SHP is associated with more percentage of poor maternal and neonatal outcomes than MHP. Fetal growth restriction can be seen more often in SHP than mild hypoprotenimea.Conclusion: Pre-eclampsia is a disease of multisystemic affection, causing liver and renal injuries, hematological abnormalities and abnormal uteroplacental blood flow. Identification of women at high risk for PE could potentially improve pregnancy outcome because intensive maternal and fetal monitoring in such patients would lead to an earlier diagnosis of the clinical signs of the disease and the associated fetal growth restriction and avoid the development of serious complications through such interventions as the administration of antihypertensive medication and early delivery. Estimation of albumin levels in pregnancy is of value in the early prediction of pre-eclampsia. SHP PE is associated with a higher risk of adverse maternal and neonatal outcomes than MHP PE, deserving closer surveillance during pregnancy