Study of Serum Calcium, Magnesium, Uric Acid and Liver Enzymes in Pregnancy Induced Hypertension

Abstract

BACKGROUND The lowering of serum calcium can cause an elevation of blood pressure in pre-eclamptic mothers. Magnesium is a potent vasodilator of uterine and mesenteric arteries and aorta. Magnesium also increases NO production causing vasodilation. Elevation of uric acid in preeclampsia is due to factors such as abnormal renal clearance, increased tissue breakdown, acidosis and a rise in the activity of the xanthine oxidase/ dehydrogenase enzyme. In preeclampsia hypervascularisation and vasoconstriction of liver leads to liver cell injury and alteration of cell membrane permeability and damage to the cells which allows intracellular enzymes to leak into the blood leading to elevated liver enzymes like AST, ALT and Alkaline phosphatase. Aims and Objectives of the Study-To estimate and compare the levels of serum calcium, magnesium, uric acid and liver enzymes in women with preeclampsia and normal pregnant women. MATERIALS AND METHODS This case control study was conducted at GGH, Vijayawada, Andhra Pradesh. Data was collected from 50 preeclampsia cases and 50 normal healthy pregnancies in the Department of Obstetrics and Gynaecology. RESULTS Mean Gestational age showed high significance with mean ± SD of cases at 36.38 ± 4.19 weeks compared to that of controls at 39.62 ± 1.16 weeks with a 'p' value of < 0.001. Systolic BP (150.4 ± 19.37 mmHg vs. 109.6 ± 7.55 mmHg) and mean ± SD of Diastolic BP (100.6 ± 14.05 mmHg vs. 75.4 ± 5.30 mmHg) of the pre-eclamptic group are significantly higher than the control group. Value of calcium in pre-eclamptic women was significantly low (8.57 ± 0.96 mg/dL vs. 9.88 ± 1.38 mg/dL; p < 0.001). Magnesium in preeclamptic women was lower than normal pregnant women (1.92 ± 0.36 mg/dL vs. 2.26 ± 0.25 mg/dL; p < 0.001). The serum uric acid in pre-eclamptic women was significantly more than normal pregnant women (6.66 ± 2.21 mg/dL vs. 4.51 ± 1.18 mg/dL, p < 0.001). ALP, AST and ALT were increased in cases compared to controls and are statistically highly significant (p < 0.001). CONCLUSION Based on the present study, serum calcium and magnesium levels are low in pre-eclamptic mothers. Pregnant women should be educated about nutrition during pregnancy and probable risks of inappropriate diet should be informed. Thus, it can be concluded that Calcium and Magnesium can be evaluated at an early date, so that such mineral deficiencies can be treated by appropriate Calcium and Magnesium supplements. Uric acid and Liver enzymes can possibly be used as biomarkers for identifying and avoiding adverse pregnancy outcomes by prompt intervention.

The Association between Gut Microbiome and Pregnancy-Induced Hypertension: A Nested Case–Control Study

“…Other studies have suggested a reduced vitamin K 2 level could be associated with insulin resistance and damage to the kidney and liver [51][52][53]. On the other hand, PIH patients had a significantly higher level of UA, GGT and INS in our study, which indicated the possibility of kidney and liver damage and metabolic abnormalities, and these alterations were found to be associated with PIH [54][55][56][57]. It is consistent that the changes of these indicators and functional modules, suggesting that they might interact with each other to participate in the occurrence of PIH.…”