Biochemical Assessment of Renal and Liver Function among Preeclamptics in Lagos Metropolis

Ekun, Oloruntoba Ayodele; Olawumi, Oluwatumininu Mary; Makwe, Christian Chigozie; Ogidi, Nkeiruka Ogochukwu

doi:10.1155/2018/1594182

Cited by 29 publications

(31 citation statements)

References 43 publications

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“…In a Nigerian population, Okonkwo and colleagues previously founda mean uric acid level of 6.05mg/dl in thirdtrimester normal pregnancies, which is comparable with the present study [25]. In pre-elamptic pregnancies, Ekun et al, Pramanik et al, Deshpande et al, Kasraeian et al respectively reported mean uric acid levels of 6.69, 6.27, 6.21, 6.20mg/dl comparable to the present study [28][29][30][31].…”

Section: Discussionsupporting

confidence: 90%

Serum Uric Acid and Plasma Glucose Levels in Normal Pregnancy

Agbecha¹

2019

AJLM

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There are existing reports of an association of uric acid with glucose metabolism and their impact on adverse pregnancy outcomes. Hyperuricemia is linked to glucose homeostasis and basically to all components of the metabolic syndrome in the general population. Based on this premise, our study aimed at determining the level of serum uric acid and plasma glucose in second and third-trimester normal pregnancies with a view of establishing cut off values in Makurdi, Nigeria. The hospital-based case-control study involved a total of 103 participants aged 18-35 years attending the antenatal and the general health check up clinics. The participants comprised of 81 normal pregnant females in their second and third trimesters compared with 22 non pregnant controls. Their fasting plasma glucose and serum uric acid levels were compared among age-matched non-pregnant women (n=22), second (n=38), and third (n=43) trimester pregnancies. Serum uric acid level in second (5.89±0.85mg/dl) and third (6.23±1.30mg/dl) trimester pregnancies were significantly (p=0.000) higher than the non-pregnant controls (3.80±1.11mg/dl). A significant (p<0.01) increase in plasma glucose was observed in third-trimester pregnancies (5.19±0.64mmol/l) compared to second-trimester pregnancies (4.87±0.79mmol/l) and controls (4.65±0.51mmol/l). The study provided cut-off values for uric acid, glucose, and further points the need for prenatal care in terms of screening and diagnosis of pregnancy complications in all pregnant women including those considered at low risk.

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Section: Discussionsupporting

confidence: 90%

Serum Uric Acid and Plasma Glucose Levels in Normal Pregnancy

Agbecha¹

2019

AJLM

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“…New onset proteinuria was defined as 300 mg or more per 24 h urine collection (or this amount extrapolated from a timed collection) or protein/creatinine ratio of 0.3 mg/dl or more or dipstick reading of 2+ (used only if other quantitative methods were not available) [ 52 , 53 ]. In the absence of proteinuria, new-onset hypertension with the new onset of any of the following were taken into account: (1) thrombocytopenia (platelet count less than 100 × 10 9 /L), (2) renal insufficiency (serum creatinine concentrations greater than 1.1 mg/dl or doubling of the serum creatinine concentration in the absence of other renal disease), and/or (3) impaired liver function (elevated blood concentrations of liver transaminases to twice the normal concentration) [ 54 , 55 , 56 ]. Other symptoms included pulmonary edema, new-onset headache unresponsive to medication, and those not accounted for by alternative diagnoses or visual symptoms [ 18 , 52 ].…”

Section: Methodsmentioning

confidence: 99%

Reduced Placental CD24 in Preterm Preeclampsia Is an Indicator for a Failure of Immune Tolerance

Sammar

Siwetz

Meiri³

et al. 2021

IJMS

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Introduction: CD24 is a mucin-like glycoprotein expressed at the surface of hematopoietic and tumor cells and was recently shown to be expressed in the first trimester placenta. As it was postulated as an immune suppressor, CD24 may contribute to maternal immune tolerance to the growing fetus. Preeclampsia (PE), a major pregnancy complication, is linked to reduced immune tolerance. Here, we explored the expression of CD24 in PE placenta in preterm and term cases. Methods: Placentas were derived from first and early second trimester social terminations (N = 43), and third trimester normal term delivery (N = 67), preterm PE (N = 18), and preterm delivery (PTD) (N = 6). CD24 expression was determined by quantitative polymerase chain reaction (qPCR) and Western blotting. A smaller cohort included 3–5 subjects each of term and early PE, and term and preterm delivery controls analyzed by immunohistochemistry. Results: A higher expression (2.27-fold) of CD24 mRNA was determined in the normal term delivery compared to first and early second trimester cases. The mRNA of preterm PE cases was only higher by 1.31-fold compared to first and early second trimester, while in the age-matched PTD group had a fold increase of 5.72, four times higher compared to preterm PE. The delta cycle threshold (ΔCt) of CD24 mRNA expression in the preterm PE group was inversely correlated with gestational age (r = 0.737) and fetal size (r = 0.623), while correlation of any other group with these parameters was negligible. Western blot analysis revealed that the presence of CD24 protein in placental lysate of preterm PE was significantly reduced compared to term delivery controls (p = 0.026). In immunohistochemistry, there was a reduction of CD24 staining in villous trophoblast in preterm PE cases compared to gestational age-matched PTD cases (p = 0.042). Staining of PE cases at term was approximately twice higher compared to preterm PE cases (p = 0.025) but not different from normal term delivery controls. Conclusion: While higher CD24 mRNA expression levels were determined for normal term delivery compared to earlier pregnancy stages, this expression level was found to be lower in preterm PE cases, and could be said to be linked to reduced immune tolerance in preeclampsia.

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“…Diagnosis of PE was based on the International Society for the Study of Hypertensive Disorders in Pregnancy (ISSHP) classification [1] in terms of diastolic blood pressure of 90 mm Hg or above or systolic blood pressure of 140 mm Hg or above, and proteinuria of 2+ in dipstick. In the case of no proteinuria, the criteria of thrombocytopenia, hemolysis, renal insufficiency, impaired liver function, or pulmonary edema were applied [1,[6][7][8][9].…”

Section: Preeclampsia (Pe) Fetal Growth Restriction (Fgr) and Pretermentioning

confidence: 99%

“…Preeclampsia (PE) is a major pregnancy complication associated with high morbidity and mortality [1][2][3][4][5]. Diagnosis of PE is made if a previously normotensive woman develops hypertension after 20 weeks gestation accompanied by proteinuria [6], and/or thrombocytopenia [7], elevated liver enzymes or hemolysis, along with the occasional involvement of other organs, mainly the cardiovascular system, the eyes, and the brain [1][2][3][4][5][6][7][8][9]. National societies of Maternal and Fetal Medicine and individual medical centers have established protocols to guide proper clinical management for saving the life of the mother and fetus/neonate and reducing morbidity [3,4].…”

Section: Introductionmentioning

confidence: 99%

Pro- and Anti-Angiogenic Markers as Clinical Tools for Suspected Preeclampsia with and without FGR near Delivery—A Secondary Analysis

et al. 2021

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Objective—the objective of this study was to assess the accuracy of placental growth factor (PlGF), soluble Fms-like Tyrosine Kinase 1 (sFlt-1), and endoglin (sEng) in the diagnosis of suspected preeclampsia (PE) with and without fetal growth restriction (FGR) near delivery. Methods—this is a secondary analysis of a dataset of 125 pregnant women presenting at the high risk pregnancy clinic with suspected PE, FGR or PE + FGR in the University Medical Center of Slovenia. The dataset included 31 PE cases, 16 FGR cases, 42 PE + FGR cases, 15 cases who developed with unrelated complications before 37 weeks (wks) (PTD), and 21 unaffected controls who delivered a healthy baby at term. We also analyzed a sub-group of women who delivered early (<34 wks) including 10 PE, 12 FGR, 28 PE + FGR, and six PTD. Clinical management adhered to hospital guidelines. Marker levels were extracted from the dataset and were used to develop Receiver Operating Characteristic (ROC) curves and to calculate the area under the curve (AUC), the detection rates (DRs), and the false positive rates (FPRs). Previously published marker cutoffs for yes/no admission to hospital wards were extracted from the literature. Negative and positive predictive values (NPVs and PPVs) were evaluated for their value in determining whether hospital admission was required. Non-parametric tests were applied for statistical analysis; p < 0.05 was considered significant. Results—near delivery, all the pro-and anti-angiogenic markers provided diagnostic (ROC = 1.00) accuracy for the early (<34 wks) group of FGR. Diagnostic or near diagnostic (ROC = 0.95) accuracy was achieved by all marker for early PE + FGR but lower accuracy was achieved for early PE. For all cases, all markers, especially PlGF reached diagnostic or near diagnostic accuracy for FGR and PE + FGR. At this accuracy level, they can contribute to the clinical management of FGR, and PE + FGR. All the markers were less accurate for all PE cases. The use of published cutoffs was adequate for clinical management of FGR, whether early or for all cases, using an NPV > 90%. For PE + FGR, the PPV value approached 100%, especially for early cases, and can thus be implemented in clinical management. Neither NPV nor PPV were high enough for managing all cases of PE. There was no added value in measuring the PlGF/(sFlt-1 + sEng) ratio. Conclusion—This is the first study on a Slovenian population. It shows that near-delivery angiogenic biomarkers tests may be useful for confirming the diseases in cases where there is a diagnostic doubt. However, the clinical use of the biomarkers needs to be weighed against resources available and degree of certainty of the diagnosis made with and without them for managing suspected FGR and PE + FGR requiring delivery <34 wks, where they are very accurate, and furthermore in the management of all cases of FGR and FGR+PE. The markers were less accurate for the clinical diagnosis of PE.

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Biochemical Assessment of Renal and Liver Function among Preeclamptics in Lagos Metropolis

Cited by 29 publications

References 43 publications

Serum Uric Acid and Plasma Glucose Levels in Normal Pregnancy

Serum Uric Acid and Plasma Glucose Levels in Normal Pregnancy

Reduced Placental CD24 in Preterm Preeclampsia Is an Indicator for a Failure of Immune Tolerance

Pro- and Anti-Angiogenic Markers as Clinical Tools for Suspected Preeclampsia with and without FGR near Delivery—A Secondary Analysis

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