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Abstract
This study included 100 pregnant females chosen from those attending Tokh Central Hospital Antenatal Care Unit, depending on the development of GH during course of pregnancy after 20 weeks’ gestational age.
All women underwent complete history taking, full clinical examination and laboratory investigations including urine analyses with determination of the level of proteinuria using urinary strips, and serum levels of uric acid, creatinine and albumin.
Patients had mean age of 22.7±5.5; range 17-41 years. There were 82 primigravida and 18 multigravida, with a mean gravidity of 2.5±0.7, range 2-4 gravida and 3 had previous abortion.
Ten patients had obstetric history of recurrent hypertension and 17 patients had a family history of gestational hypertension. There were 94 pregnant who with singleton fetus, whereas the other six had twin pregnancy.
Patients had mean GA of 28.1±4.3; range 20-36 weeks, at time of development of GH. First trimester data recorded for patients included in the study mean systolic blood pressure 114.4±6.8; range 100-125 mmHg, mean diastolic blood pressure 74±4.3; range 65-85 mmHg; mean serum creatinine was 1±0.18, range 0.75-1.2 mg/dl, mean serum uric acid was 3.8±0.85, range 2.2-5.5 mg/dl and mean serum albumin was 3.32±0.52, range 2.2-4.5 mg/d1. No patient had proteinuria.
At time of inclusion in the study, there was significant (P<0.05) elevation of both systolic and diastolic blood pressures and a significant increase of serum uric acid, but there was a non-significant (P>0.05) increase and decrease in serum levels of creatinine and albumin, respectively, in comparison to data determined at first trimester.
Through follow-up 18 ( 15 primi and 3 multigravida ) developed preeclampsia at a mean GA of 31.6±2.1 weeks, range 28-35 weeks with the mean time elapsed since inclusion in the study (time of getting GH) till progress to preeclampsia 4.7±3.1; range 2-12 weeks. Four preeclamptic patients were found to have multiple pregnancies, whereas the other 14 patients had singleton fetus.
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Summary
Retro pective analysis of blood pressure measurements and laboratory findings at 1st trimester and at time of inclusion in patients that developed pre-eclampsia revealed a
significant those devel and diastoli GH. Moreo either GH o developed developme significant compared t proteinuria, (+++) protei with multiple
Ther eclampsia (r=0.345, P (r=0.357, P occurrence hypertensio correlation P>0.05) an regression occurrence and serum
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<0.05) increase of both systolic and diastolic pressures in comparison to ped GH, moreover, there was a significant increase (P<0.05) of both systolic pressures in preeclamptic primigravida compared to primigravida de \;eloped er, serum uric acid showed a significant (P<0.05) increase at development of pre-eclampsia compared to levels detected at first trimester, and in patients re-eclampsia compared to those with GH either at 1st trimester or at time of t of pre-eclampsia. On contrary, serum creatinine and albumin showed a non-P>0.05) increase and decrease, respectively, in all study participants
the estimates determined at 1st trimester. All pre-eclamptic patients had patients mild (+) proteinuria, 6 patients moderate (++) and only 3 had severe uria. There was a significant increase (P<0.05) in serum uric acid in pre-eclamptics regnancy, compared to those with singleton fetus.
was a positive significant correlation between the occurrence of Are-nd systolic blood pressure, (r=0.517, P<0.001), diastolic blood pressure, 0.001), mean Blood pressure, (r=0.407, P<0.001) and serum uric acid levels, 0.001). Whereas there was a negative significant correlation between the of preeclampsia and gestational age at presentation with gestational
(r=-0.331, P=0.001). On the other hand, there was non-significant etween occurrence of pre-eclampsia and serum creatinine levels, (r=0.148, serum albumin levels and (r=-0.131, P>0.05). However, application of logistic stepwise exclusion method) revealed that the most significant predictors of f pre-eclampsia are the estimation of systolic blood pressure, gestational age ric acid level at time of enrollment.
Id be concluded from this study that the progression of a pregnant woman gestational hypertension to develop preeclampsia is insidious, no single uld be relied upon to define cases that will progress to preeclampsia and the n of the three predictors ; namely systolic blood pressure, gestational age and acid levels at time of development of gestational hypertension could cases that will progress to preeclampsia.