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Dr. Soniya Ilyas
Dr. Faiza Nawaz Khan
Dr. Amna Halima
Dr. Farhat Rehman
Dr. Zarka Sarwar
Dr. Atifullah Dawar


Preeclampsia, serum uric acid, blood pressure, proteinuria, second trimester


Background: Hypertension during pregnancy is a worldwide problem having serious consequences for the mother as well as the fetus. Uric acid is the end product of purine metabolism catalyzed by enzyme xanthine dehydrogenase/oxidase through several stimuli including ischemia. It is potent mediator of inflammation and through stimulation of inflammatory cytokines cause endothelial injury. Serum uric acid levels are proportional in women with pre-eclampsia.

Objective: To determine mean serum uric acid levels among pre-eclamptic women in the second trimester of pregnancy.

Material and methods:

Study Design: Descriptive cross-sectional

Setting: Pakistan Atomic Energy General Hospital Islamabad

Duration: 6 months from approval of synopsis i.e. 31-5-2018 to 1-12-2018

Data Collection Procedure: 100 indoor patients were included in the study. Data was collected using Performa which includes personal data of patients. 5ml of venous sample was taken from patients for quantification of serum uric acid level. Data was analyzed using version 21.0 of SPSS.

Results: The mean age of patients was 32.20±4.89years. The mean BMI of patients was 23.99±3.24kg/m2. The mean gestational age of patients was 22.11±1.46weeks. The mean blood pressure of patients was 150.40±7.34mmHg. The mean uric acid level was 7.25± 1.64mg/dl.

Conclusion: The average uric acid was high in females with preeclampsia and more than half of females had above-normal level of serum uric acid.

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1. Obstetricians ACo, Gynecologists. Hypertension in pregnancy.Report of the American College of Obstetricians and Gynecologists’ Task Force on hypertension in pregnancy. Obstetrics and gynecology 2013;122(5):1122.
2. Sibai BM. Magnesium sulfate prophylaxis in preeclampsia: Lessons learned from recent trials. American journal of obstetrics and gynecology 2004;190(6):1520-6.
3. Bulusu R, Singh T. ANALYSIS OF SERUM URIC ACID LEVELS IN EARLY SECOND TRIMESTER AS AN EARLY PREDICTOR FOR PREECLAMPSIA. Journal of Evidence Based Medicine and Healthcare 2017;4(3):115-8.
4. Gifford R. Report of the national high blood pressure education program working group on high blood pressure in pregnancy. Am J ObstetGynecol 2000;183:S1-S15.
5. Laganà AS, Favilli A, Triolo O, Granese R, Gerli S. Early serum markers of pre-eclampsia: are we stepping forward? The Journal of Maternal-Fetal & Neonatal Medicine 2016;29(18):3019-23.
6. Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstetrics & Gynecology 2003;102(1):181-92.
7. Ness RB, Roberts JM. Heterogeneous causes constituting the single syndrome of preeclampsia: a hypothesis and its implications. American journal of obstetrics and gynecology 1996;175(5):1365-70.
8. Vatten LJ, Skjærven R. Is pre‐eclampsia more than one disease? BJOG: An International Journal of Obstetrics &Gynaecology 2004;111(4):298-302.
9. Villar J, Betran A, Gulmezoglu M. Epidemiological basis for the planning of maternal health services. WHO/RHR 2001;111:298-.
10. Perez-Cuevas R, Fraser W, Reyes H, Reinharz D, Daftari A, Heinz CS, et al. Critical pathways for the management of preeclampsia and severe preeclampsia in institutionalised health care settings. BMC pregnancy and Childbirth 2003;3(1):6.
11. Ngoc NTN, Merialdi M, Abdel-Aleem H, Carroli G, Purwar M, Zavaleta N, et al. Causes of stillbirths and early neonatal deaths: data from 7993 pregnancies in six developing countries. Bulletin of the World Health Organization 2006;84:699-705.
8. Maesaka JK, Fishbane S. Regulation of renal urate excretion: a critical review. American journal of kidney diseases 1998;32(6):917-33.
9. Desideri G, Puig J, Richette P. The management of hyperuricemia with urate deposition. Current medical research and opinion 2015;31(sup2):27-32.
10. Meneses-Leon J, Denova-Gutiérrez E, Castañón-Robles S, Granados-García V, Talavera JO, Rivera-Paredez B, et al. Sweetened beverage consumption and the risk of hyperuricemia in Mexican adults: a cross-sectional study. BMC public health 2014;14(1):445.
11. Kim S, De Vera M, Choi H. Gout and mortality. Clinical & Experimental Rheumatology 2008;26(5):S115.
12. Lin F, Zhang H, Huang F, Chen H, Lin C, Zhu P. Influence of changes in serum uric acid levels on renal function in elderly patients with hypertension: a retrospective cohort study with 3.5-year follow-up. BMC geriatrics 2016;16(1):35.
13. Ding X, Zeng C, Wei J, Li H, Yang T, Zhang Y, et al. The associations of serum uric acid level and hyperuricemia with knee osteoarthritis. Rheumatology international 2016;36(4):567-73.
14. Yang T, Ding X, Wang Y-l, Zeng C, Wei J, Li H, et al. Association between high-sensitivity C-reactive protein and hyperuricemia. Rheumatology international 2016;36(4):561-6.
15. Li M, Hou W, Zhang X, Hu L, Tang Z. Hyperuricemia and risk of stroke: a systematic review and meta-analysis of prospective studies. Atherosclerosis 2014;232(2):265-70.
16. Liu L, Lou S, Xu K, Meng Z, Zhang Q, Song K. Relationship between lifestyle choices and hyperuricemia in Chinese men and women. Clinical rheumatology 2013;32(2):233-9.
17. Ioannou GN, Boyko EJ. Effects of menopause and hormone replacement therapy on the associations of hyperuricemia with mortality. Atherosclerosis 2013;226(1):220-7.
18. Enomoto A, Kimura H, Chairoungdua A, Shigeta Y, Jutabha P, Cha SH, et al. Molecular identification of a renal urate–anion exchanger that regulates blood urate levels. Nature 2002;417(6887):447.
19. Ichida K, Hosoyamada M, Kimura H, Takeda M, Utsunomiya Y, Hosoya T, et al. Urate transport via human PAH transporter hOAT1 and its gene structure. Kidney international 2003;63(1):143-55.
20. Leal-Pinto E, Cohen BE, Lipkowitz MS, Abramson RG. Functional analysis and molecular model of the human urate transporter/channel, hUAT. American Journal of Physiology-Renal Physiology 2002;283(1):F150-F63.
21. Shiraishi H, Une H. The effect of the interaction between obesity and drinking on hyperuricemia in Japanese male office workers. Journal of epidemiology 2009;19(1):12-6.
22. Martinon F, Pétrilli V, Mayor A, Tardivel A, Tschopp J. Gout-associated uric acid crystals activate the NALP3 inflammasome. Nature 2006;440(7081):237.
23. Dalbeth N, Merriman T. Crystal ball gazing: new therapeutic targets for hyperuricaemia and gout. Rheumatology 2008;48(3):222-6.
24. Latourte A, Bardin T, Richette P. Prophylaxis for acute gout flares after initiation of urate-lowering therapy. Rheumatology 2014;53(11):1920-6.
25. Xie D-x, Xiong Y-l, Zeng C, Wei J, Yang T, Li H, et al. Association between low dietary zinc and hyperuricaemia in middle-aged and older males in China: a cross-sectional study. BMJ open 2015;5(10):e008637.
26. Wang Y-l, Zeng C, Wei J, Yang T, Li H, Deng Z-h, et al. Association between dietary magnesium intake and hyperuricemia. PloS one 2015;10(11):e0141079.
27. Sun SZ, Flickinger BD, Williamson-Hughes PS, Empie MW.Lack of association between dietary fructose and hyperuricemia risk in adults. Nutrition & metabolism 2010;7(1):16.
28. Yamamoto T, Moriwaki Y, Takahashi S. Effect of ethanol on metabolism of purine bases (hypoxanthine, xanthine, and uric acid). ClinicaChimicaActa 2005;356(1-2):35-57.
29. Shimizu Y, Nakazato M, Sekita T, Kadota K, Arima K, Yamasaki H, et al. Relationships of adult body height and BMI status to hyperuricemia in general Japanese male population: The Nagasaki Islands Study. ActaMedicaNagasakiensia 2013;58(2):57-62.
30. Pramanik T, Khatiwada B, Pradhan P. Serum uric acid level in normal pregnant and preeclamptic ladies: a comparative study. Nepal Medical College journal : NMCJ 2014 Sep;16(1):30-2.
31. Wu Y, Xiong X, Fraser WD, Luo Z-C. Association of uric acid with progression to preeclampsia and development of adverse conditions in gestational hypertensive pregnancies. American journal of hypertension 2012;25(6):711-7.
32. Mustaphi R, Gopalan S, Dhaliwal L, Sarkar A. Hyperuricemia and pregnancy induced hypertension--reappraisal. Indian journal of medical sciences 1996;50(3):68-71.
33. Roberts JM, Bodnar LM, Lain KY, Hubel CA, Markovic N, Ness RB, et al. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension 2005;46(6):1263-9.
34. Bainbridge SA, Roberts JM. Uric acid as a pathogenic factor in preeclampsia. Placenta 2008;29Suppl A(Suppl A):S67-S72.