Abstract: Background:1. Hypertension is one of the common medical complications of pregnancy and contributes significantly to maternal and perinatal morbidity.
2. The identification of Pre-eclampsia and effective management play a significant role in the outcome of pregnancy, both for mother and baby.
3. In developing countries like India, with inadequately cared pregnancy, this entity remains undetected till major complications supervene.
4. Henceforth this is a study attempt to predict the development of pre-eclampsiafrom maternal serum uric acid levels in 1st and early 2nd trimester(<20 wks) and assess the perinatal outcome.
Objectives: To predict preeclampsia and to assess perinatal outcomes from serum uric acid level testing in 1st and early 2nd trimester (<20 wks).
Method: All pregnant women in their 1st and early 2nd trimester(up to 20 Wks gestation) visiting OPD and also in-patients at MVJMC&RH are explained about the study, with informed consent, their serum uric acid levels are measured. These women are followed up in their antenatal visits and also during peripartal period for development of any features of pre-eclampsia and also the perinatal outcome assessed in terms of IUGR, NICU admission, low APGAR scores, low birth weight and other complications. The patients who developed preeclampsia are grouped as preeclampsia Cohort. The patients who are normotensive till delivery are grouped as normal cohort. The factors taken for analysis are age, obstetric score, serum uric acid APGAR score, birth weight, NICU admission.
Results: A total of 100 cases of pregnant women in 1st and early 2nd trimester (upto 20 wks) were included in this study with maximum number of patients in the age group of 26-30years (42%) and most were primigravida (45%).Out of 21 patients who developed preeclampsia,15(71.4%) had positive serum uric acid test, out of 6 women who delivered IUGR babies,4(66.7%) had positive uric acid test.Among 100 women, 30 women delivered babies required NICU care. among these 30, 21(70%) had positive maternal uric acid test antenatally, out of 39 who had APGAR score at 1min <7, 28(71.8%) babies had positive maternal serum uric acid test and out of 36 who had APGAR score at 5min <7, 22(61.1%) babies had positive maternal serum uric acid test. Out of 28 low birth weight babies (<2.5kg),22(78.6%) had positive maternal serum uric acid test.
Interpretation and Conclusion: In present study increased serum uric acid level in first trimester and early 2nd trimester(<20 wks) is associated with development of preeclampsia in later weeks of pregnancy and also raised level of serum uric acid level in first trimester and early 2nd trimester(<20 wks) helps to determine fetal and maternal outcome and is associated with increased risk of preeclampsia, low birth weights(<2.5 kg), low APGAR scores and increased NICU admissions.
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