The Change of Serum Uric Acid in Pregnancy Induced Hypertension and It's Clinical Implication

Objectives:To speculate importance of the change in serum uric acid in pregnancy induced hypertension(PIH) and the clinical importance to predict the PIH and their perinatal outcome.Methods: 6580 normal gravidas serum uric acid levels were tested in 26～27 Gestational weeks,among them,187 pregnant women complicated by PIH afterwards(mild PIH n=46,moderate PIH n=46 and severe PIH n=95).Their serum uric acid were tested again in one week before labor.Normal gravidas (n=40) and nonpregant normal women (n=30) were randomly chosen as a control and their serum uric acid was tested.Results: In 26～27gestational weeks,the serum uric acid levels were significantly higher in moderate PIH(212.73±67.24)and severe PIH(238.31±95.06)than that in mild PIH(189.52±49.97)and normal pregnant women(199.43±48.61)(P0.01,P0.05).There was no significant difference(P0.05) in serum uric acid levels among mild PIH?normal gravidas and nonpregnant women(199.43±48.61).In normal gravidas and PIH,the uric acid levels were significantly higher in all groups one week before labour than 26～27 gestation week(P0.01).One week before labour,the uric acid levels in normal pregnancy(253.31±58.64)was significantly higher than that in nonpregrant normal women(214.76±43.44),(P0.05),the uric acid levels were significantly higher in severe PIH(408.46±119.85)than that in mild PIH(271.43±73.86)and moderate PIH(312.62±72.91),(P0.01),there was no difference in serum uric acid(P0.05)among normal gravidas mild PIH and moderate PIH.Of the severe PIH,the incidence of abnormal eyeground and proteinuria of 24 hours5 g was higher in high serum uric acid group than normal uric acid group(P0.05,P0.01).The incidence of abnormal electrocardiogram,abnormal liver function and abnormal renal function was no significantly difference(P0.05).The incidence of HELLP syndrom,heart failure,kidney failure,eyeground bleeding,DIC and abruption placentae was no significant difference between the two groups(P0.05).To the severe PIH,the incidence of unfavorable perinatal prognosis was significant higher in high uric acid group(79.17%)than normal uric acid group(34.04%),(P0.01),perinatal mortality was higher in high uric acid group than normal uric acid group.Conclusions: The rise of serum uric acid level was associated with PIH and can predict their perinatal outcome.It is very important to test serum uric acid continuously during pregnancy for getting a favorable perinatal outcome.