Article Sidebar
Main Article Content
Abstract
ABSTRACT
BACKGROUND. Eclampsia is the most dangerous maternal complication in hypertensive disorders of pregnancy (HDP). Hyperuricemia is a sign of poor prognosis for both the mother and the fetus. We investigated the relationship between uricemia and the occurrence of eclampsia in cases of severe pre-eclampsia.
MATERIALS AND METHODS. This was a three-month’ cross-sectional study carried out in two tertiary hospitals in the city of Yaoundé, Cameroon. All patients attending the hospitals with evidence of severe pre-eclampsia or eclampsia and willing to participate in the study were enrolled. Socio-epidemiology data and blood were collected as soon as the diagnosis was made; uricemia were measured using a spectrophotometric method. Statistical analyses were performed using SPSS 18.0 and significance was observed when P was <0.05.
RESULTS. Ninety five pregnant women, aged between 15 to 41 years, with evidence of severe pre-eclampsia (60) or eclampsia (35) were enrolled during the months of January to march 2015. While age below 20 years increased the risk of eclampsia (OR=4.2; IC= [1.2-15]; P =0.002), marital status, parity, educational level, gestational age at time of diagnosis, the timing with respect to labor, and blood pressure values did not influence significantly the risk of developing eclampsia. Interestedly, we found that hyperuricemia is significantly increased in eclamptic patients (OR=3.1; IC= [1.2-8.2]; P=0.001).
CONCLUSION. This study suggests that blood uric acid levels are greater in eclamptic patients especially in younger ones.
KEYS WORDS. Severe preeclampsia, eclampsia, hyperuricemia, eclamptic seizures, Yaoundé, Cameroon.
RÉSUMÉ
INTRODUCTION. L’éclampsie est une des complications maternelles les plus redoutées en cas de toxémie gravidique. L’élévation de l’uricémie est un signe de mauvais pronostic materno-fœtal. Le but de l’étude était de rechercher s’il existe une corrélation entre l’uricémie et la survenue de crises convulsives en cas de pré éclampsie sévère.
MÉTHODOLOGIE. Nous avons réalisé une étude prospective analytique comparative dans 02 formations sanitaires de la ville de Yaoundé sur une période de trois mois. Toutes les patientes ayant présenté une pré-éclampsie sévère ou une éclampsie étaient recrutées et un dosage sanguin de l’acide urique était réalisé. Les données collectées étaient analysées à l’aide des logiciels SPSS version 18.0 et Epi info version 7. Le test de Chi carré a permis de comparer les variables d’intérêt entre les deux groupes avec un seuil de significativité P<0,05.
RÉSULTATS. Au total, 95 cas ont été recrutés soit 60 cas de pré-éclampsie sévère et 35 cas d’éclampsie. L’âge <20 ans augmentait le risque d’éclampsie (OR=4,2 ; IC= [1,2-15] ; P=0,0). Le statut matrimonial, la parité, le niveau d’instruction, l’âge gestationnel au moment du diagnostic, le moment de survenue de la maladie par rapport au travail, de même que le niveau des chiffres tensionnels n’ont pas influencé pas de façon significative la survenue des crises convulsives. L’hyperuricémie était augmentée de façon significative en cas d’éclampsie (OR=3,1 ; IC= [1,2-8,2] ; P=0,001).
CONCLUSION. Nous avons pu établir que l’hyperuricémie était plus élevée en cas d’éclampsie surtout chez les jeunes femmes.
MOTS CLÉS. Preéclampsie sévère, éclampsie, hyperuricémie, crises d’éclampsie, Yaoundé, Cameroun.
Keywords
Article Details
References
- References
- Mayi-Tsonga S, Akouo L, Ngou-Mve-Ngou JP, Meye JF. Risk factors for eclampsia in Libreville (Gabon): A case-control study. Sante (Montrouge, France).2006 ; 16(3):197-200. doi:10.1684/san.2006.0026.
- Faye A, Picaud A, Ogowet-igumu N, Nlome, Nzé RA, Nicolas PH. Eclampsia in Libreville central hospital. 53 cases in 41.285 deliveries in 1985-1989. Rev Fr Gynecol Obst. 1991; 86: 503-10.
- Pambou O, Ekoundzola JR, Malanda JP, Buambo S. management and prognosis of eclampsia in the university teaching hospital in Brazzaville: a retrospective study of 100 cases. Med Afr Noire. 1999; 46: 508-512.
- Mbu RE, Dempouo, Nana PN, Tonye RN, Ako S, Eteki NT, Leke RI. The materno-fœtal outcome of eclamptic women who give birth by caesarean or vaginal route in 3 tertiary hospitals in Yaoundé. Clinics Mother Child Health.2006; 3(2): 555-62.
- Yakana NI. Evolution of maternal mortality after reorganisation of the obstetric service: the case of the Central maternity in Yaoundé [thesis] (2003): Faculty of Medecine and Biomedical Sciences. University of Yaoundé I
- Mboudou ET, Foumane P, Belley PE, Dohbit J, Ze MJ, Nkengafac WM, Doh AS. Hypertension during pregnancy: epidemiological and clinical aspects at the Gyneco-Obstetric and Pédiatric Hospital of Yaoundé, Cameroon. Clin Mother Child Health 2009; 6 (2): 1087-93.
- Buambo-Bamanga SF; Ngbale R; Makoumbou P, Ekoundzola JR. eclampsia in the university teaching hospital in Brazzaville, Congo. Clin mother child health. 2009; 6 (2): 1129-33.
- Coulibaly KT , Abhé CM , Ouattara A. , Yapi N , Assa NL , Binlin-Dadié RY. the complications of preeclampsia in resuscitation's department of the teaching hospital of Cocody (Abidjan - RCI). Rev Afr Anesth Med Urgence. 2014 ; 19 (1). http://saranf.net/Les-complications-de-la-pre.html
- Kang DH, Finch J, Nakagawa T, Karumanchi SA, Kanellis J, Granger J, Johnson RJ. Uric acid, endothelial dysfunction and pre-eclampsia: searching for a pathogenetic link. J Hypertens. 2004; 22(2) : 229-35.
- Lam C, Lim KH, Kang DH, Karumanchi SA. Uric acid and preeclampsia. Semin Nephrol. 2005; 25(1) : 56-60.
- Chen Q, Lau S, Tong M, Wei J, Shen F, Zhao J, Zhao M. Serum uric acid may not be involved in the development of preeclampsia. J Hum Hypertens. 2016; 30, 136-40.doi: 10.1038/jhh.2015.47. [Epub ahead of print]
- Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, Tuttle KR, Rodriguez-Iturbe B, Herrera-Acosta J, Mazzali M. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 2003; 41:1183–90.
- Bainbridge SA., Roberts JM. Uric Acid as a Pathogenic Factor in Preeclampsia. Placenta. 2008; 29: 67–72.
- Tchaou BA , Tshabu-Aguèmon C , Hounkponou FM , Brouh Y , Aguémon AR , Chobli M. Serious obstetric morbidity in intensive care unit in the the University Teaching Hospital of Parakou (Benin) about 69 cases. Rev Afr Anesth Med Urgence. 2013; 18 (1). http://saranf.net/Morbidites-obstetricales-graves-en.html
- Baeta S, Tete KVS, Noutsougan YM, Nya-me AN, Akpadza KS. Eclampsia in CHU in Lomé (Togo): risk factors, maternal and perinatal prognosis. SAGO Journal 2002 ; 1 : 1-6
- Masoura S, Makedou K, Theodoridis T, Kourtis A, Zepiridis L, Athanasiadis A. The Involvement of Uric Acid in the Pathogenesis of Preeclampsia. Curr Hypertens Rev. 2015;11(2):110-5.
- Voto LS, Illia R, Darbon-Grosso HA, Imaz FU, Margulies M. Uric acid levels: a useful index of the severity of preeclampsia and perinatal prognosis. J Perinat Med. 1988;16: 123-6.
- Roberts JM, Bodnar LM, Lain KY, Hubel CA, Markovic N, Ness RB, Powers RW. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension. 2005;46:1263-9.
- Elmas O, Elmas O, Aliciguzel Y, Simsek T. The relationship between hypertension and plasma allantoin, uric acid, xanthine oxidase activity and nitrite, and their predictive capacity in severe preeclampsia. J Obstet Gynaecol. 2015 Sep ; 14:1-5.
- Carter J, Child A. Serum uric acid levels in normal pregnancy. Aust N Z J Obstet Gynaecol. 1989; 29:313-4.
- Powers RW, Bodnar LM, Ness RB, Cooper KM, Gallaher MJ, Frank MP, Daftary AR, Roberts JM. Uric acid concentrations in early pregnancy among preeclamptic women with gestational hyperuricemia at delivery. Am J Obstet Gynecol. 2006; 194:160
- Cicero AF, Degli Esposti D, Immordino V, Morbini M, Baronio C, Rosticci M, Borghi C. Independent Determinants of Maternal and Fetal Outcomes in a Sample of Pregnant Outpatients with normal blood pressure, Chronic Hypertension, Gestational Hypertension, and Preeclampsia. J Clin Hypertens. 2015; 17(10):777-82.
- Ben Salem F, Ben Salem K, Grati L, et al. Risk factors of eclampsia: a case-control study. Ann Fr Anesth Rea. 2003. 22: 865-9
References
References
Mayi-Tsonga S, Akouo L, Ngou-Mve-Ngou JP, Meye JF. Risk factors for eclampsia in Libreville (Gabon): A case-control study. Sante (Montrouge, France).2006 ; 16(3):197-200. doi:10.1684/san.2006.0026.
Faye A, Picaud A, Ogowet-igumu N, Nlome, Nzé RA, Nicolas PH. Eclampsia in Libreville central hospital. 53 cases in 41.285 deliveries in 1985-1989. Rev Fr Gynecol Obst. 1991; 86: 503-10.
Pambou O, Ekoundzola JR, Malanda JP, Buambo S. management and prognosis of eclampsia in the university teaching hospital in Brazzaville: a retrospective study of 100 cases. Med Afr Noire. 1999; 46: 508-512.
Mbu RE, Dempouo, Nana PN, Tonye RN, Ako S, Eteki NT, Leke RI. The materno-fœtal outcome of eclamptic women who give birth by caesarean or vaginal route in 3 tertiary hospitals in Yaoundé. Clinics Mother Child Health.2006; 3(2): 555-62.
Yakana NI. Evolution of maternal mortality after reorganisation of the obstetric service: the case of the Central maternity in Yaoundé [thesis] (2003): Faculty of Medecine and Biomedical Sciences. University of Yaoundé I
Mboudou ET, Foumane P, Belley PE, Dohbit J, Ze MJ, Nkengafac WM, Doh AS. Hypertension during pregnancy: epidemiological and clinical aspects at the Gyneco-Obstetric and Pédiatric Hospital of Yaoundé, Cameroon. Clin Mother Child Health 2009; 6 (2): 1087-93.
Buambo-Bamanga SF; Ngbale R; Makoumbou P, Ekoundzola JR. eclampsia in the university teaching hospital in Brazzaville, Congo. Clin mother child health. 2009; 6 (2): 1129-33.
Coulibaly KT , Abhé CM , Ouattara A. , Yapi N , Assa NL , Binlin-Dadié RY. the complications of preeclampsia in resuscitation's department of the teaching hospital of Cocody (Abidjan - RCI). Rev Afr Anesth Med Urgence. 2014 ; 19 (1). http://saranf.net/Les-complications-de-la-pre.html
Kang DH, Finch J, Nakagawa T, Karumanchi SA, Kanellis J, Granger J, Johnson RJ. Uric acid, endothelial dysfunction and pre-eclampsia: searching for a pathogenetic link. J Hypertens. 2004; 22(2) : 229-35.
Lam C, Lim KH, Kang DH, Karumanchi SA. Uric acid and preeclampsia. Semin Nephrol. 2005; 25(1) : 56-60.
Chen Q, Lau S, Tong M, Wei J, Shen F, Zhao J, Zhao M. Serum uric acid may not be involved in the development of preeclampsia. J Hum Hypertens. 2016; 30, 136-40.doi: 10.1038/jhh.2015.47. [Epub ahead of print]
Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, Tuttle KR, Rodriguez-Iturbe B, Herrera-Acosta J, Mazzali M. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 2003; 41:1183–90.
Bainbridge SA., Roberts JM. Uric Acid as a Pathogenic Factor in Preeclampsia. Placenta. 2008; 29: 67–72.
Tchaou BA , Tshabu-Aguèmon C , Hounkponou FM , Brouh Y , Aguémon AR , Chobli M. Serious obstetric morbidity in intensive care unit in the the University Teaching Hospital of Parakou (Benin) about 69 cases. Rev Afr Anesth Med Urgence. 2013; 18 (1). http://saranf.net/Morbidites-obstetricales-graves-en.html
Baeta S, Tete KVS, Noutsougan YM, Nya-me AN, Akpadza KS. Eclampsia in CHU in Lomé (Togo): risk factors, maternal and perinatal prognosis. SAGO Journal 2002 ; 1 : 1-6
Masoura S, Makedou K, Theodoridis T, Kourtis A, Zepiridis L, Athanasiadis A. The Involvement of Uric Acid in the Pathogenesis of Preeclampsia. Curr Hypertens Rev. 2015;11(2):110-5.
Voto LS, Illia R, Darbon-Grosso HA, Imaz FU, Margulies M. Uric acid levels: a useful index of the severity of preeclampsia and perinatal prognosis. J Perinat Med. 1988;16: 123-6.
Roberts JM, Bodnar LM, Lain KY, Hubel CA, Markovic N, Ness RB, Powers RW. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension. 2005;46:1263-9.
Elmas O, Elmas O, Aliciguzel Y, Simsek T. The relationship between hypertension and plasma allantoin, uric acid, xanthine oxidase activity and nitrite, and their predictive capacity in severe preeclampsia. J Obstet Gynaecol. 2015 Sep ; 14:1-5.
Carter J, Child A. Serum uric acid levels in normal pregnancy. Aust N Z J Obstet Gynaecol. 1989; 29:313-4.
Powers RW, Bodnar LM, Ness RB, Cooper KM, Gallaher MJ, Frank MP, Daftary AR, Roberts JM. Uric acid concentrations in early pregnancy among preeclamptic women with gestational hyperuricemia at delivery. Am J Obstet Gynecol. 2006; 194:160
Cicero AF, Degli Esposti D, Immordino V, Morbini M, Baronio C, Rosticci M, Borghi C. Independent Determinants of Maternal and Fetal Outcomes in a Sample of Pregnant Outpatients with normal blood pressure, Chronic Hypertension, Gestational Hypertension, and Preeclampsia. J Clin Hypertens. 2015; 17(10):777-82.
Ben Salem F, Ben Salem K, Grati L, et al. Risk factors of eclampsia: a case-control study. Ann Fr Anesth Rea. 2003. 22: 865-9