The Diagnostic Value of Hepatic and Renal Biochemical Tests for the Detection of Preeclampsia Among Pregnant Women Attending the Antenatal Care Clinic at the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia

Abstract

Background: Preeclampsia has a deleterious effect on renal and liver function, which results in alterations of various biochemical tests. Therefore, the main aim of this study was to evaluate the role of some hepatic and renal biochemical tests in the diagnosis of preeclampsia. Methods: A comparative cross-sectional study was carried out on a total of 126 pregnant women after 20th week of gestation who attended at the University of Gondar Comprehensive Specialized Hospital. The participants were divided into two groups as cases and controls. The case group consisted of 63 preeclamptic women, whereas the control group had 63 age and gestational week matched normotensive pregnant women. From each participant, three milliliters of blood was collected, the serum part was separated, and selected biochemical tests were measured using Humastar 800 chemistry analyzer. An independent t-test and receiver operating characteristics were done using SPSS 20 for comparison and diagnostic value determination of different biochemical tests between the study groups. Results: The maternal serum aminotransferases, total bilirubin, Creatinine, and Urea levels were all significantly elevated in preeclamptic women compared to normotensive pregnant women. The receiver operating characteristics plots revealed that serum aspartate aminotransferase level had area under the curve of 0.89 (95% CI: 0.84-0.95) and can distinguish preeclampsia patients from normotensive pregnant women at cut-off value of ≥58.5 U/l with 74.6% sensitivity, 87.3% specificity, and 80.9% diagnostic accuracy. Serum Creatinine level had area under the curve of 0.91 (95% CI: 0.86-0.96), which enabled to indicate preeclampsia at a cut-off value ≥0.90 mg/dl with 77.8% sensitivity and 85.7% specificity. Conclusion: An increased serum aminotransferases, total bilirubin, creatinine, and Urea levels in pregnant women could indicate the development of preeclampsia, and needs to be investigated. Among biochemical tests, serum Creatinine level was the best diagnostic marker of preeclampsia, followed by serum aspartate aminotransferase level.

Association of Reduced Maternal Plasma Cholinesterase Activity With Preeclampsia: A Meta-Analysis

“…This is due to the fact that the reduction is only 15.15% as found in the present meta-analysis, and there are discrepancies in the literature regarding the extent of changes in activity expected in pregnancy with PE (reviewed in Table 2). It is possible that the determination of BChE activity during PE could be of value for assessment and follow-up, especially in the initial stages of monitoring and evaluation of the hypertension condition, when used collectively with other biomarkers such as liver enzymes, blood biochemical measurements, and oxidative stress markers [5][6][7][8][9][10][11]48].…”

“…It is characterized by elevated maternal blood pressure (systolic > 140, diastolic > 90 mmHg) with > 0.3 g proteinuria in 24 h urine collection; in severe cases of PE the systolic and diastolic blood pressures may exceed 160 and 110 mmHg, respectively, with 24 h urine proteinuria of > 5 g, as well as disorders involving one or more of the major organ systems of the body [1,2]. In addition to these clinical findings, accumulated evidence from many studies has suggested that several biochemical changes could be considered biomarkers of PE [3][4][5]. These include but are not limited to elevation of activities of liver function enzymes [5], increased serum uric acid [6], hepcidin [7] and cytokine [8] levels, Vit D3 deficiency [9] or changes in blood cholinesterase (ChE) activity [10,11] and increased oxidative stress condition in the blood [12].…”

“…In addition to these clinical findings, accumulated evidence from many studies has suggested that several biochemical changes could be considered biomarkers of PE [3][4][5]. These include but are not limited to elevation of activities of liver function enzymes [5], increased serum uric acid [6], hepcidin [7] and cytokine [8] levels, Vit D3 deficiency [9] or changes in blood cholinesterase (ChE) activity [10,11] and increased oxidative stress condition in the blood [12].…”