Role of biochemical markers in preeclampsia

ABSTRACT

To evaluate the relation of serum paraoxonase and lipid profile parameters and Plasma Fibronectin in mild and severe preeclamptic women and it's relation to the anticibated fetal outcome. Prospective controlled trial. Obstetric emergency unit in Kasr Al-Eini Hospital, Cairo University. 120 pregnant patients between 37-40 weeks gestation admitted to Obstetric emergency unit, they are divided into three groups, 40 controls, 40 with mild preeclampsia [PE] and 40 with severe preeclampsia [PE]. All patients in each group were subjected to estimation of maternal serum paraoxonase, lipidogram and plasma fibronectin and to Trans Abdominal Ultrasound for Fetal biometry, Fetal biophysical profile. Neonatal outcome will be assessed by Apgar score at 5 minutes and Neonatal birth weight. Maternal serum triglycerides, total cholesterol, High density lipoprotiens [HDL]-cholesterol, Low density lipoprotiens [LDL]-cholesterol, total cholesterol/HDL-cholesterol ratio, maternal serum paraoxonase. Plasma fibronectin, fetal biophysical profile, Neonatal birth weight, Apgar score 5 min. The results revealed significant elevations in serum triglycerides, total cholesterol, LDL-cholesterol and total cholesterol/ HDL- cholesterol ratio and plasma fibronectin in preeclamptic patients. Meanwhile, significant reduction in paraoxonase activity and HDL cholesterol depending on severity of preeclampsia was found which was directly related with decreased fetal biophysical profile, fetal birth weight and Apgar score 5 minutes especially in severe cases. These results suggest that decreased serum paraoxonase activity as well changes in lipid profile may be responsible for the oxidative stress in the pathogenesis of preeclampsia. It can he concluded that assessment of serum paraoxonase activity and maternal plasma fibronectin may be applied among the parameters used in monitoring pregnant women with PE, as well assessment of severity of PE and evaluation of anticipated fetal outcome. Yet a Randomized controlled trial with larger number of patients is needed