TMSS Medical College Journal

Background: Preeclampsia is a multi-system disorder that can affect 5-8% of all pregnancies and is a major contributor to maternal and perinatal morbidity and mortality. There is no single test to fulfill all the criteria for a good predictor of preeclampsia. Objective: To determine the outcome of pregnancy in preeclampsia with impaired renal functions. Materials and Methods: This analytic observational study was carried out in the Department of Obstetrics and Gynaecology in Rangpur Medical College Hospital, Rangpur, from January 2025 to December 2025. 20 preeclamptic patients with impaired renal function were considered as group A and 80 preeclamptic patients with normal renal function were considered as group B. Results: Out of these 100 study subjects, serum creatinine and uric acid levels were deranged in group A compared to group B. Maternal and perinatal complications were higher among group A than group B. Conclusion: Impaired creatinine and uric acid levels in preeclampsia adversely affect pregnancy outcome. Therefore, prior information in such patients may help to reduce perinatal and maternal morbidity and mortality.

reeclampsia is the most challenging clinical entityaffecting both mother and fetus. It is a predisposingfactor for maternal as well as perinatal morbidity andmortality. Incidence of preeclampsia in developingnation has been reported to be around 4-18%.!Preeclampsia is defined as pregnancy specificsyndrome observed usually after 20 weeks of gestationwith systolic blood pressure > 140mmHg and diastolicblood pressure > 90 mmHg accompanied by signifi-cant proteinuria with or without edema. Severepreeclampsia is associated with elevated bloodpressure >160/110 mmHg, on two occasions at least 6hrs apart, on bed rest; with proteinuria > 5gm in 24 hrsurine sample; along with other symptoms such asheadache, visual disturbances, hyper reflexia, epigas-tric or right upper quadrant pain, vomiting, oliguria,impaired liver function and _ thrombocytopenia(HELLP Syndrome).’ In most of the cases, about 75%preeclampsia appear to be mild and 25% are severe.’Serum uric acid and creatinine levels are a part of work up for the pregnant women with hypertension. Theelevated levels of these parameters were due todecreased urinary clearance secondary to reduced GFRand increased reabsorption.* Serum uric acid is notonly a marker of severity of disease but also contrib-utes to the pathology of disorder.* Serum uric acid is amarker of oxidative stress, tissue injury and renaldysfunction. It is the product of purine metabolism andis synthesised by the enzyme xanthine oxidase.Hypoxia and ischemia of the placenta and cytokinessuch as interferon induce the expression of xanthineoxidase and therefore increase production of uric acidand reactive oxygen species. In uncomplicated preg-nancies, serum uric acid concentration fall in first and2™ trimester 25-35 % due to an elevation in renal clear-ance secondary to increased GFR or reduced proximaltubular re-absorption and due to changes in its produc-tion rate continue to remain low during second trimes-ter and slowly and slowly increase during thirdtrimester, possibly due to raised fetal production,decreased binding to albumin and a decline in uric acidclearance until towards the end of pregnancy.° Several studies have reported a positive correlationbetween elevated maternal serum uric acid and creati-nine adversely affect maternal and foetal outcome.’ Upto now, there is no reliable, valid, and cost-effectivescreening test for the early detection of preeclampsia.It seems that measuring the blood level of uric acid andcreatinine is one of the available and cheap screeningtests that may help to early detection of the disease.