value of urinary calcium in prediction of pregnancy induced hypertension [PIH]

ABSTRACT

Maternal and perinatal mortality and morbidity still remain high if PIH is diagnosed late. One hundred normotensive primigravidae participated in this work. Starting from first trimester, the 24 hour urinary calcium excretion was measured at the end of each trimester. Ninety one cases completed follow up program, of them 11 [12%] developed PIH during the third trimester [7 pre eclampsia and 4 gestational hypertension]. The mean 24 hour urinary calcium excretion was significantly reduced [P < 0.001] in patients with pre-eclampsia [172 +/- 9.8 mg / 24 hour] and in patients with gestational hypertension [249.5 +/- 5.9 mg / 24 hour] compared to the normotensive group [296.5 +/- 21.2 mg / 24 hour]. The level was significantly reduced [P < 0.001] during the second trimester in cases who ultimately developed pre eclampsia in third trimester. Similar finding was not observed in gestational hypertension group. This work shows that measurement of urinary calcium during the second trimester is a good indicator for the ultimate development of pre eclampsia in addition to its value in confirming diagnosis of already developed pre eclampsia