Abstract
Background: Pre-eclampsia is a pregnancy-specific syndrome. It affects 3-5% of pregnant women and is characterized by oedema, high blood pressure, and proteinuria. Moreover, in women with pre-eclampsia dysfunction of many organs, such as kidney and liver, is diagnosed, while in the case of foetus growth restriction is observed. Pre-eclampsia, when left untreated, can lead to a high mortality rate. In low-income countries, this disorder is one of the main causes of maternal and child mortality. Pre-eclampsia predisposes women in later life to cardiovascular diseases. So far, in acute cases of pre-eclampsia stabilization of the mother and fotus, and finally, termination of pregnancy at a time optimal for both sides can only be considered.
Methods: The present work is designed to investigate the relationship between pre-eclampsia, renal and hepatic insufficiency in the Al-Jouf area through collecting information from the electronic database of maternity hospital for 100 pregnant women who suffered from pre-eclampsia compared with normal pregnancies.
Results: The prevalence of pre-eclampsia is more prone in eldest women (older than 35 years old) almost 45% than younger women (20-25 years old), PC to MPV ratio value showed a significant suppression in pre-eclamptic pregnancies in comparison with normal pregnant women while HbA1c % value indicated a significant increase in the pre-eclamptic cases than the healthy pregnant women. Renal indices, serum creatinine, urea, and albumin were significantly higher in the pre-eclamptic women than in women with normal pregnancies.
Conclusion: There is a tight relationship between hypertensive disorders during pregnancies, chronic renal disorders and hepatic insufficiency.
References
Tranquilli AL, Dekker G, Magee L, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertens 2014; 4(2): 97-104.
https://doi.org/10.1016/j.preghy.2014.02.001
Mol BW, Roberts CT, Thangaratinam S, et al. Pre-eclampsia. Lancet 2016; 387(10022): 999-1011.
https://doi.org/10.1016/S0140-6736(15)00070-7
Douglas KA, Redman CW. Eclampsia in the United Kingdom. BMJ 1994; 309(6966): 1395-400.
https://doi.org/10.1136/bmj.309.6966.1395
Shennan AH, Redman C, Cooper C, et al. Are most maternal deaths from pre-eclampsia avoidable? Lancet 2012; 379(9827): 1686-1687.
https://doi.org/10.1016/S0140-6736(11)60785-X
Lain KY, Roberts JM. Contemporary concepts of the pathogenesis and management of preeclampsia. JAMA 2002; 287: 3183.
https://doi.org/10.1001/jama.287.24.3183
Btett CY, Richard JL and Ananth SK. Pathogenesis of Preeclampsia, Annual review of Pathology: Mechanism of Disease 2010; Vol.5: 173-192.
https://doi.org/10.1146/annurev-pathol-121808-102149
McMaster-Fay RA. "Pre-eclampsia: a disease of oxidative stress resulting from the catabolism of DNA (primarily fetal) to uric acid by xanthine oxidase in the maternal liver; a hypothesis". Bioscience Hypotheses 2008; 1: 35-43.
https://doi.org/10.1016/j.bihy.2008.01.002
Laresgoiti-Servitje E, Gómez-López N and Olson DM. "An immunological insight into the origins of pre-eclampsia". Hum Reprod Update 2010; 16 (5): 510-524.
https://doi.org/10.1093/humupd/dmq007
Excellence. NIfHaC. CG107 NICE Guideline: Hypertension in Pregnancy.2012.
Bartsch E, Medcalf KE, Park AL, et al. High Risk of Pre-eclampsia Identification, Group "Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies". BMJ 2016; 353: i1753.
https://doi.org/10.1136/bmj.i1753
Van den Boogaard E, Vissenberg R, Land JA, et al. "Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review". Human Reproduction Update (Review). 2011; 17 (5): 605-619.
https://doi.org/10.1093/humupd/dmr024
Mol BW, Roberts CT, Thangaratinam S, et al. Pre-eclampsia. Lancet. 2016; 387(10022): 999-1011.
https://doi.org/10.1016/S0140-6736(15)00070-7
Al-Jameil N, Aziz Khan F, Fareed Khan M, et al. "A brief overview of preeclampsia". Journal of clinical medicine research 2014; 6 (1): 1-7.
Arulkumaran N and Lightstone L. "Severe pre-eclampsia and hypertensive crises". Best Practice & Research Clinical Obstetrics & Gynaecology 2013; 27 (6): 877-884.
https://doi.org/10.1016/j.bpobgyn.2013.07.003
Sibai, BM. Hypertension. In S. G. Gabbe, J. R. Niebyl, J. L. Simpson, M. B. Landon, H. L. Galan, E. R. M. Jauniaux, & D. A. Driscoll (Eds.), Obstetrics: Normal and problem pregnancies 2012; Philadelphia, PA: W. B. Saunders.
Haram K, Svendsen E, and Abildgaard U. The HELLP syndrome: Clinical issues and management. A review. BMC Pregnancy & Childbirth 2009; 9: 8.
https://doi.org/10.1186/1471-2393-9-8
Leeman L, Dresang LT, and Fontaine P. Hypertensive disorders of pregnancy. American Family Physician 2016; 93(2), 121-127.
Igberase G and Ebeigbe P. Eclampsia: ten-years of experience in a rural tertiary hospital in the Niger delta, Nigeria. Journal of Obstetrics and Gynaecology 2006; 26(5): 414-417.
https://doi.org/10.1080/01443610600720113
Adamu YM, Salihu HM, Sathiakumar N, et al. Maternal mortality in Northern Nigeria: a population-based study. European Journal of Obstetrics Gynecology and Reproductive Biology 2003; 109(2): 153-159.
https://doi.org/10.1016/S0301-2115(03)00009-5
Duley L. Pre-eclampsia and the hypertensive disorders of pregnancy. British Medical Bulletin 2003; 67: 161-176.
https://doi.org/10.1093/bmb/ldg005
Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implication. Journal of Maternal-Fetal and Neonatal Medicine 2009; vol. 22, no. 3, pp. 183-190.
Salafia CM, Pezzullo JC, Lo?pez-Zeno JA, et al. Placental pathologic features of preterm preeclampsia. Am J Obstet Gynecol 1995; 173: 1097-1105.
https://doi.org/10.1016/0002-9378(95)91333-5
Zhou Y, Damsky CH, Chiu K, et al. Preeclampsia is associated with abnormal expression of adhesion molecules by invasive cytotropho- blasts. J Clin Invest 1993; 91: 950-960.
https://doi.org/10.1172/JCI116316
Hennessy A and Makris A. Preeclamptic nephropathy. Nephrology 2011; 16: 134-143.
https://doi.org/10.1111/j.1440-1797.2010.01411.x
Kayode O, Osungbade and Olusimbo K. Ige. Public Health Perspectives of Preeclampsia in Developing Countries: Implication for Health System Strengthening 2011; 2011, 6-9.
https://doi.org/10.1155/2011/481095
Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol. 2003; 102(1): 181-192.
https://doi.org/10.1097/00006250-200307000-00033
Duley L. Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America and the Caribbean. Br J Obstet Gynaecol 1992; 99: 547-553.
https://doi.org/10.1111/j.1471-0528.1992.tb13818.x
Maynard SE, Min JY, Merchan J, et al. Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J Clin Invest 2003; 111: 649-658.
https://doi.org/10.1172/JCI17189
Venkatesha S, Toporsian M, Lam C, et al. Soluble endoglin contrib- utes to the pathogenesis of preeclampsia. Nat Med 2006; 12: 642-649.
https://doi.org/10.1038/nm1429
Cornelis T, Odutayo A, Keunen J, et al. The kidney in normal preg- nancy and preeclampsia. Semin Nephrol 2011; 31: 4-14.
https://doi.org/10.1016/j.semnephrol.2010.10.002
Garovic VD, Wagner SJ, Turner ST, et al. Urinary podocyte excretion as a marker for preeclampsia. Am J Obstet Gynecol 2007; 196: 320.e1-320.e7.
https://doi.org/10.1016/j.ajog.2007.02.007
Henao DE, Mathieson PW, Saleem MA, et al. A novel renal perspec- tive of preeclampsia: a look from the podocyte. Nephrol Dial Trans- plant 2007; 22: 1477.
https://doi.org/10.1093/ndt/gfl804
Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. Am J Obstet Gynecol 1982; 142: 159-167.
https://doi.org/10.1016/S0002-9378(16)32330-4
Bearelly D, Hammoud GM, Koontz G, et al. Preeclampsia- induced liver disease and HELLP syndrome. In: Ibdah, J. A., ed. Maternal Liver Disease. 1st ed. Austin, TX: Landes Bioscience 2012; 73-92.
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