“EVALUATION OF LIVER FUNCTION TESTS WITH AND WITHOUT PREECLAMPSIA”

Abstract

Introduction: Hypertensive disorders of pregnancy (HDP) are among obstetrics' most intriguing and yet unsolved problem. HDP is blood pressure greater than or equal to 140/90 mmHg, with each measurement usually corroborating within 4 hours. Hyperuricemia indicates kidney dysfunction in preeclampsia because of decreased glomerular filtration, decreased tubular secretion, and/or
increased proximal tubular reabsorption. It is also an independent risk factor for cardiovascular diseases as it has been suggested that it alters vascular function and mediates vascular inflammation. As such, hyperuricemia can perhaps predict the severity of pre-eclampsia. Preeclampsia is also the most common cause of liver dysfunction in 3% of pregnancies because of micro vesicular fat deposition and reduced blood flow to the liver potentially causing ischemia and peri-portal haemorrhage Aim and Objectives: This aim and objectives of our study were to measure and compare the levels of uric acid and liver function tests in pregnant women with and without preeclampsia at our tertiary care hospital. Materials and methods: Approximately 5 ml of venous blood was collected in a sterile plain vacutainer tube and properly labelled with a specific code of the patient. Blood collected in SST tubes was allowed to stand for 30 minutes at room temperature to allow complete clotting and clot retraction. It was then centrifuged at 3500 rpm for 15–30 min to extract serum. The serum was kept at -80°C refrigerators until biochemical analysis was carried out. The extracted serum was used to determine the biochemical levels (uric acid, aspartate aminotransferase (AST), and alanine aminotransferase (ALT)) using automated biochemistry analyser. Results and Discussion: In the present study, we included a total of 100 pregnant women, out of
100, 50 were physician confirmed cases of preeclampsia and 50 were normal pregnant women, who had come for routine antenatal check-up at our tertiary care hospital. The mean age, gestational age (in weeks) in normal pregnant women were found to be 30.9±5.8 years, 33.6±5.8 and in preeclampsia were found to be 28.9±4.7 years and 34.6±3.98 weeks respectively. We measured total bilirubin, direct bilirubin, ALT, AST and uric acid levels in both the groups, we did not find statistically significant differences in the levels of total bilirubin and direct bilirubin levels between the two groups. We compared ALT, AST and uric acid levels between the two groups, we found elevated levels of ALT, AST and uric acid levels in preeclampsia patients compared to normal pregnancy group. This elevation was statistically significant. In the present study, preeclamptic patients were positively and significantly associated with SUA,
ALT, and AST levels. Preeclampsia was associated with a marked increase in SUA, AST, and ALT levels compared to controls. This was in line with other studies Conclusion: In the present study, we found that the serum uric acid, ALT, and AST levels were higher in pre-eclampsia pregnant women compared to those of normotensive pregnant women, and the differences were statistically significant.