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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6318.9

Abstract

Hypertensive disorder in pregnancy is a common disease. The incidence of pregnancy induced hypertension (PIH) in India range from 5 -15%. Though the exact cause of PE is still undecided, endothelial dysfunction with associated intense vasospasm has been implicated in its causation. Recently homocysteine, a metabolite of essential aminoacid methionine, has been postulated to produce oxidative stress and endothelial cell dysfunction. The present study is aimed at the estimation of homocysteine concentration in both pre-eclamptic and normotensive pregnant women, thereby deducing its relation in causation of preeclampsia. The present study was carried out in 90 pregnant women of whom 45 were Preeclampsia (cases) and 45 were normotensive pregnant women(controls) admitted to R.L.Jalappa Medical College, Kolar, Maternal serum homocysteine levels were measured by ELISA method.

Results: In the present study  of 45 preeclamptic women and 45 normotensive pregnant women in whom the serum homocysteine levels were compared. Majority of the subjects were in the age group of 21 -25years in both the groups. All the ninety subjects were primigravida. We have found that there is a statistically significant correlation between serum homocysteine levels and severity of PE i.e. the mean serum Hcy levels in controls (7.9±1.3 mol/l), mild preeclampsia (14.5±3.2 mol/ l) and severe preeclampsia (19.6±3.9 mol/ l). Serum homocysteine levels increased with increasing severity of PE with p - value being highly significant (p<0.001). Significant positive correlation was found between serum homocysteine levels and SBP and DBP i.e. with increase in SBP and DBP there was significant increase in serum homocysteine in preeclampsia. In our study, hyperhomocysteinemia was associated with poor pregnancy outcome in preeclampsia; IUGR (48.9%), Preterm (28.9%) and SGA (15.6%).

Interpretation and Conclusion: Homocysteine concentration decreases during normal pregnancy, but this does not occur in preeclampsia. In preeclampsia there is increase in levels of homocysteine compared to normotensive women. In PET, homocysteine levels further increase with increasing severity of preeclampsia. Hyperhomocysteinemia is associated with poor pregnancy outcome.

Keywords: Homocysteine; Normotensive; Preeclampsia.

 

Corresponding Author : S. Naga Jyothi, Senior Resident, Department of Obstetrics and Gynaecology, Sri Devaraj Urs Medical college and Research centre, SDUAHER, Kolar, Karnataka 563101, India.