ABSTRACT
Aims: We studied some blood cell changes and alterations in renal and hepatic functions in pregnancy and pre-eclampsia and determined baselines for the population in owerri, south east Nigeria. Study Design: It was a cross sectional case control study conducted prospectively among antenatal women attending clinic at Holy Rosary, Federal Medical Centre and General Hospitals Owerri. The study included fifty non-pregnant, fifty pre-elampsia and fifty normotensive pregnant women of singleton gestation in their third trimester Place and Duration of Study: Sample: Antenatal unit of Holy Rosary, Federal Medical Centre and General Hospitals Owerri between May 2009 and June 2010. Methodology: The study included fifty (50) non-pregnant women, fifty (50) pregnant normotensive women and fifty (50) pre-eclamptic women of singleton gestation in their third trimester. Full blood count, liver function enzymes assay and some kidney function parameters was determined in all subjects. The subjects were selected under defined criteria. PE patients were at 28 to 42 wks of single-diastolic pressure of 110mmHg or more or two measurements of 90mmHg or more on two consecutive occasions of 6hours or more apart, urinary protein 2+ or more. The exclusion criteria include history of hypertension and proteinuria before conception or before 20wks of gestation, a history of antioxidant vitamins therapy during the last one year and smoking. Results: The result showed a significant (P = 0.05) decrease in Red cell distribution width coefficient of variance (RDW-CV), mean cell haemoglobin (MCH), platelet count (PC) and mean platelet volume- platelet count (MPV-PC) ratio in pre-eclampsia comaperd to normal pregnancy. Significant increases (P= 0.05) in red blood cell count, haemoglobin concentration, haematocrit, mean cell volume, mean platelet volume, platelet distribution width (PDW) and circulating large platelet ratio (PLCR) were found among the pre-eclamptic women. There was a significant (P = 0.05) increase in ALT, AST, ALP and LDH activities in pre-eclampsia when compared to both the normal and the pregnant controls. Urea, Creatinine and Uric acid concentrations had a significant increase (P = 0.05) in pre-eclampsia when compared to normal and pregnant controls Conclusion: The significant variation seen in these red cell parameters between the PC and NPC is attributable mainly to pregnancy than to pre-eclampsia. Pre-eclampsia though resulted in a marked platelet usage with a resulting shorter platelet life-span. A burden on the liver and kidney resulting from pre-eclampsia could have adversely affected protein metabolism which in turn may have affected erythropoesis. Results indicate that renal function is impaired in the presence of pre-eclampsia.
ABSTRACT
Background: Definition of iron deficiency anaemia could be problematic in areas where iron deficiency co-exists with infection. Aim: This study was aimed at providing the prevalence of anaemia in pregnancy in Port Harcourt and to examine the diagnostic role of serum iron indicators and C- reactive protein in defining iron deficiency anaemia. Methods: Iron status indicators; serum iron; TIBC; percentage transferrin saturation; serum ferritin; haemoglobin concentration and C-reactive protein were assessed in 1;371 pregnant women and 60 age-matched non-pregnant controls using standard colorimetric; immunoassay and serologic procedures. Results: Iron deficiency anaemia was present in 5of our apparently healthy non-pregnant women and in 8.9of the pregnant women. Iron deficiency (ferritin 12 ng/ml) accounted for 15of anaemia in the control group and 18.0of anaemia in the pregnant women. Elevated C-reactive protein (20 mg/l) was found to be common with the anaemic pregnant women (40.2) compared with 6.7among non-pregnant control group (p0.0001). The Hb; serum iron; TIBC;transferrin saturation and serum ferritin levels in anaemic pregnant women were found to be significantly lower than the non-pregnant control group (p0.0001) while the C-reactive protein level in the anaemic pregnant women was significantly higher than the non-pregnant control group (p0.0001). Conclusion: The prevalence of iron deficiency anaemia among apparently pregnant women in this locality is high. Part of the contributory factor may be infection or inflammation; hence; ferritin alone may not reliably define anaemia in pregnancy. A combination of haemoglobin concentration; transferrin saturation and serum ferritin concentration should form a regular practice in order to assist in reducing the incidence of anaemia in pregnancy