Evaluation of serum urea, creatinine and total proteinin pre-eclamptic women attending antenatal care

Thesis Abstract

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.