The Role of Serum Uric Acid in Predicting Adverse Pregnancy Outcome in Preeclampsia at Aminu Kano Teaching Hospital

Abstract

Background: Pre-eclampsia is a complex multi-systemic complication of pregnancy. Serum uric acid has been studied as one of the prognostic factors for adverse pregnancy outcomes in pre-eclampsia. The study evaluated adverse pregnancy outcomes associated with hyperuricemia in preeclampsia in Aminu Kano Teaching hospital (AKTH), Kano. Study Design: This was a hospital-based prospective cohort study. Methodology: One hundred consecutive pre-eclamptic patients admitted into the labour ward during the study period were recruited. They were managed according to the standard treatment protocol. Their socio-demographic and clinical variables such as age, parity, admitting blood pressure, proteinuria, estimated gestational age, and presence of symptoms, fetal birth weight, Apgar scores and admission into special care baby unit were recorded. Adverse perinatal outcomes of IUGR, IUFD and Birth Asphyxia as well as Maternal complications of Eclampsia, HELLP syndrome and acute renal failure were recorded. Levels of maternal serum uric acid, liver enzymes, platelets and Bilirubin were determined and recorded. Results: Seventy per cent had severe preeclampsia. Majority (43%) of the cases were unbooked, with no formal (15%) or only primary education (43%). Mean gestational age was lower (34.32±3.212 vs 35.11±3.315, p<0.001), and the babies weighed less (2.58±0.8 vs 3.26±0.6, p <0.001) in the severe pre-eclamptic group. Hyperuricaemia (Serum Uric Acid =450ìMol/l) is found in 39% of patients and is significantly associated with intrauterine fetal death (IUFD), HELLP syndrome, severe hypertension and elevated liver enzymes (LD, AST). The mean platelets count was lower and significantly
associated with hyperuricemia.