This study, ”Evaluation of urea, creatinine and total proteins in pre-eclamptic women” was carried out in Abia State University Teaching Hospital, Aba, Abia State. Total of Sixty(60) subjects aged 25-40 were recruited for the study and they were divided into two groups made up of 30 pre-eclamptic women and 30 apparently healthy pregnant women. The study showed that the mean value of the maternal age of test subjects (34.03±4.60 years) was significantly different (P=0.02) when compared with the mean value of the maternal age of control(30.97±4.8years) at P<0.05. The results of the mean values of the systolic blood pressure(165.47±17.46mmHg) and diastolic blood pressure (118.07±8.60mmHg) of test subjects was significantly higher (P=0.0001) when compared with the mean values of the systolic blood pressure(119.20±3.02mmHg) and diastolic blood pressure(76.99±9.02mmHg) of control subjects at P<0.05. It was observed that there was no significant difference(P=0.180 and P=0.598) in the mean values of Serum Total Protein (57.76±11.38g/l) and Urea(29.07±8.83mg/dl) in test subjects when compared with the mean values of Serum Total Protein(60.86±5.79g/l)and Urea(27.73±10.05mg/dl) in control group at P>0.05 respectively. Though serum total protein was slightly decreased and urea slightly increased in test subjects when compared with the control subjects but was not significant. The results also showed a significant increase in the mean values of creatinine in the test subjects(1.21±0.61mg/dl) when compared with the mean values of creatinine in the control subjects (0.44±0.36mg/dl) at P<0.05.Based on this observations, plasma creatinine concentration could serve as a biochemical marker in pre-eclampsia.
1.1 Background Introduction
Pre-eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. Pre-eclampsia is a disorder of pregnancy characterized by the onset of high blood pressure and often a significant amount of protein in urine (proteinuria). The condition begins after 20 weeks of pregnancy(AL-Jameil et al.,2014).In severe disease, there may be red blood cell breakdown, a low blood platelet count,impaired liver function, kidney dysfunction, swelling, shortness of breath due to fluid in the lungs or visual disturbance. If left untreated , it may result to seizures known as eclampsia(AL-Jameil et al.,2014).
Pre-eclampsia is also a known complication in pregnancy affecting about 8-10% of all women. It is often characterized by hypertension and damages the blood vessels of the brain, liver, lungs and kidney, which can lead to multiple organ failure, convulsion, coma, or even death. The majority of death related to hypertensive disorder can be avoided by providing timely and effective care to women presenting with such complications (Campbell and Graham, 2016). Thus, optimization of healthcare for women during pregnancy to prevent hypertensive disorders is a necessary step towards achieving the Millennium Development Goals (MDG).
Obesity, chronic hypertension, and diabetes are among the risk factors of pre-eclampsia which also include nulliparity adolescent pregnancy and conditions leading to hyperplacentation and large placentas (example: twin pregnancy ). In most settings, pre-eclampsia is classified as severe when any of the following conditions are present: severe hypertension, heavy proteinuria or substantial maternal organ dysfunction. Maternal death can occur among severe cases but the progression from mild to severe can be rapid, unexpected and occasionally fulminant. Management of women with pre-eclampsia aims at minimizing further pregnancy-related complications, avoiding unnecessary premature birth and maximizing maternal and infant survival. Delaying the interruption of pregnancy may lead to progression of pre-eclampsia, eventually resulting in placental insufficiency and maternal organ dysfunction.
1.2 Justification of the study
Pre-eclampsia stands out among the hypertensive disorder for its impact on maternal and neonatal health. It is the most common hypertensive disease of pregnancy affecting 2-8% of pregnancies (Saflas et al., 2010) and accounting for nearly 18% of maternal deaths(ACOG,2002).However, the pathogenesis of pre-eclampsia is only partially understood and it is said to be related to disturbances in placentation at the beginning of pregnancy, followed by generalized inflammation and progressive endothelial damage. Pre-eclampsia is also associated with adverse fetal outcomes including intrauterine growth retardation andq placental abruption (Wagner, 2011).
The changes of urea, creatinine and total protein are worth assessing for in pre-eclamptic patients. Moreover, previous works have shown discordant reports on the association of pre-eclampsia and high plasma level of urea and creatinine. This work is therefore focused on evaluating urea,creatinine and total protein in pre-eclamptic women. So as to see if support or otherwise will be given to the previous claims.
1.3 Aims and Objectives
- A) General Objective:
To evaluate total protein, urea and creatinine levels in pre-eclamptic patients undergoing antenatal care in Abia State University Teaching Hospital (ABSUTH)
Aba, Abia State.
- B) Specific Objectives
1) To determine the levels of total protein in pre-eclamptic women
2) To determine urea and creatinine levels in pre-eclamptic patients
3) To compare the levels of total protein, urea and creatinine in preeclamptic women with the normotensive pregnant women.