LOW PLATELET COUNT SERUM URIC ACID AND SERUM CREATININE AS A PROGNOSTIC INDICATOR IN PREGNANCY INDUCED HYPERTENSION

Dr. Sanjaya Sharma; Dr. Sushila Kharakwal; Dr. Ayesha Anjum

Volume : IX, Issue : VI, June - 2020

LOW PLATELET COUNT SERUM URIC ACID AND SERUM CREATININE AS A PROGNOSTIC INDICATOR IN PREGNANCY INDUCED HYPERTENSION

Dr. Sanjaya Sharma, Dr. Sushila Kharakwal, Dr. Ayesha Anjum

Abstract :

Background and Objective: Preeclampsia is associated with variable maternal and perinatal complications. It has been indicated that increased serum uric acid and low platelet count play a prognostic role in preeclampsia. The present study was undertaken to evaluate severity of preeclampsia with raised S. uric acid and low platelet count and to evaluate perinatal outcome in preeclampsia with these parameters. Methods: Study was done on women with hypertensive diseases of the pregnancy at Maharani Laxmi Bai Medical College and Hospital, Jhansi (U.P). After approval by the Ethical committee, patients were recruited in the study by obtaining written informed consent. 511 pregnant females were included in the study out of which 260 were taken as controls and 251 were taken as cases. Demographic, clinical and biochemical data at time of referral and delivery were collected for each pregnant women. Women were grouped according to diagnosis (gestational hypertension, mild preeclampsia, severe preeclampsia or eclampsia) and logistic regression analysis was used to determine relationship between serum uric acid and low platelet count with adverse outcomes. Result: Out of 511 patients 251 were cases out of which 67 (26.69%) patient were severe preeclampsia. The mean level of uric acid in these women was significantly higher than in non severe preeclampsia. 83 (33.06%) women were diagnosed as eclampsia and were associated with significantly high serum uric acid levels, high serum creatinine levels and low platelet count and adverse perinatal outcomes like neonatal deaths and low birth weight. Conclusion: In conclusion, our observations indicate that serum uric acid level is better indicator for the diagnosis of non severe PE even in the absence of positive USG observations. Platelet count may be a good indicator for the detection of milder form of preeclampsia. However for the severe form both serum uric acid and serum creatinine detect the severity. Additionally, continuous serial monitoring of the platelet count may indicate the progression of the disease. Serum creatinine values have positive correlation with the severity of the disease due to the ongoing renal pathology. Even though our data provide greater predictor value for platelet count, uric acid level and serum creatinine, the cutoff or threshold levels that change the progression cannot be ascertained. Additional study is required to find the critical levels.