Gestational hypertension; maternal and fetal outcome in women with role of hyperurecemia

ABSTRACT

Aim of the study was to ascertain prospectively the prognostic value of serum uric acid for fetal and maternal outcomes in women with gestational hypertension. This prospective study was conducted at department of Gynae and Obs, Maternal and Child Health Center, PIMS Islamabad, from January to December 2003. A total of 200 women with a gestational age >20 weeks, and blood pressure >130/90 mmHg were inducted in the study. At presentation serum uric acid, creatinine, hemoglobin, and platelets were measured along with blood pressure. All patients were divided into group A [uric acid <4.5 mg/dl] and group B [>4.5 mg/dl] and were followed for one month after the delivery to record pregnancy and neonatal outcome. A significant difference [p<0.05] in the levels of uric acid, hemoglobin, platelet count, creatinine and blood pressure was noted between patients of group A and B. A significant decrease [p<0.05] in preterm delivery, baby birth weight and increase in fetal mortality was noted in patients of group B as compared to those of group A. Regarding maternal outcome preeclampsia [p=0.005, CI 0.143-0.689], deranged liver functions [p=0.000, CI 0.062-0.397], and disseminated intravascular coagulation [p=0.005; CI 0.049-0.626] was noted in patients of group B as compared to group A. The patients of Group B showed a significant low birth weight, increased fetal mortality rate [p=0.005, CI 0.030-0.622] and more chances of shifting neonates to NICU [p=0.002, CI 0.164-0.667] as compared to those of group A. Hyperuricaemia in setting of gestational hypertension was associated with adverse fetal and maternal outcome: