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Panminerva Medica 2000 June;42(2):101-3

lingua: Inglese

The clinical utility of serum uric acid measurements in pre-eclampsia and transient hypertension in pregnancy

D’Anna R., Baviera G., Scilipoti A., Leonardi I., Leo R.

From the Department of Ginecology University Polyclinic, Messina, Italy


Background. Our pur­pose was to eval­uate the clin­ical ­utility of ­serum ­uric ­acid meas­ure­ments in the hyper­ten­sion dis­eases of preg­nancy.
Methods. We iden­ti­fied 286 ­women and cat­e­go­rized ­them ­into ­three diag­nostic ­groups ­according to def­i­ni­tions of hyper­ten­sive dis­eases in preg­nancy pub­lished by the National Working Group on Hypertension in Pregnancy: pre-­eclampsia (94), tran­sient hyper­ten­sion (102) and ­normal (90). We com­pared the ­median ­uric ­acid con­cen­tra­tion for ­each ­group and cal­cu­lated the sen­si­tiv­ities and the spec­i­fic­ities in diag­nosing pre-­eclampsia. The ­results ­were ana­lyzed by the Mann-Whitney ­test.
Results. Median ­serum ­uric ­acid ­values in the pre-­eclamptic ­group, in the tran­sient hyper­ten­sion ­group and in the con­trol ­group ­were 375 (262-536) ­μmol/L, 309 (214-387) ­μmol/L, 259 (143-339) ­μmol/L, respec­tively. Compared ­with ­normal, the ­median ­serum ­uric ­acid ­levels in ­women ­with pre-­eclampsia or tran­sient hyper­ten­sion ­were sig­nif­i­cantly ele­vated. Differences in ­median ­serum ­uric ­acid con­cen­tra­tions ­between ­women ­with pre­eclampsia and ­with tran­sient hyper­ten­sion ­were sta­tis­ti­cally sig­nif­i­cant too. The prev­a­lence of ­IUGR in the pre-­eclamptic ­group and tran­sient hyper­ten­sion ­group was 65.9% and 29.4%, respec­tively. Sensitivity for ­serum ­uric ­acid ­levels of 339 ­μmol/L was 77.3% in the pre-­eclamptic ­group and 32.3% in the tran­sient hyper­ten­sion ­group; the dif­fer­ence was sta­tis­ti­cally sig­nif­i­cant. Specificity was ­exactly the ­same in ­both ­groups (92%).
Conclusions. Our ­data, in accor­dance ­with inter­na­tional lit­era­ture, con­firm the clin­ical ­utility of ­serum ­uric ­acid as a ­marker of pre-­eclampsia, but not of tran­sient hyper­ten­sion. Furthermore its ­high pre­dic­tive ­value ­makes it pos­sible to ­select a ­group of pre-­eclamptic ­women ­with ­high ­risk for intra­ute­rine ­growth retar­da­tion.

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