Predictive value of biochemical markers in pregnancy induced hypertension

ABSTRACT

Hypertensive disorders of pregnancy complicate 10% of all pregnancies. They include gestational hypertension, preeclampsia, eclampsia, and chronic hypertension. The aim of this study was to identify predictive markers for early diagnosis of women who are at risk of gestational hypertension or preeclampsia. This study was conducted on a total of 64 cases. Twenty nine were pregnant females who developed pregnancy induced hypertension and 35 females were normotensive throughout pregnancy with normal pregnancy outcome taken as controls. Subjects were recruited from the Prenatal Diagnosis Clinic, at the National Research Center. Maternal blood samples were taken as part of the department's routine second trimester biochemical screening program at 14- 20 weeks gestation. All cases were subjected to the estimation of human chorionic gonadotropin [hCG], tumor necrosis factor alpha [TNF- alpha], C-reactive protein [CRP], nitric oxide [NO] and the lipid peroxidation product malondialdehyde [MDA], in addition to the estimation of lipid profiles [cholesterol [Ch], high density lipoprotein cholesterol [HDLc], low density lipoprotein cholesterol [LDLc] and triglycerides [TG]], urea and creatinine. The study showed significant increase of [beta-hCG, TNF-alpha, CRP, MDA, urea, creatinine, TG, Ch and LDLc in women who developed PIH compared with normotensive pregnant women, while NO was significantly decreased in women who developed PIH compared with normotensive pregnant women. It could be concluded that the elevated levels of TNF-alpha, beta-hCG, CRP and MDA, in addition to decreased levels of NO and abnormal lipid profiles were implicated in subsequent risk for PIH. Furthermore TNF-alpha and MDA may be considered as important predictive markers for early detection of PIH