Blood uric acid level as a marker of increased risk of eclampsia in severe pre-eclamptic patients: A cross-sectionnal study in two tertiary hospitals in Yaoundé, Cameroon.

Félix ESSIBEN, Olivier Itembe, Pascal Foumane, Marcelle Tsafack de Nguefack, Filbert Eko Eko

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


preéclampsie sevère, éclampsie, hyperuricémie, crises d’éclampsie, Yaoundé, Cameroun.

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