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.

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 Yaounde, 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, Yaounde, Cameroon. RESUME INTRODUCTION. L’eclampsie est une des complications maternelles les plus redoutees en cas de toxemie gravidique. L’elevation de l’uricemie est un signe de mauvais pronostic materno-fœtal. Le but de l’etude etait de rechercher s’il existe une correlation entre l’uricemie et la survenue de crises convulsives en cas de pre eclampsie severe. METHODOLOGIE. Nous avons realise une etude prospective analytique comparative dans 02 formations sanitaires de la ville de Yaounde sur une periode de trois mois. Toutes les patientes ayant presente une pre-eclampsie severe ou une eclampsie etaient recrutees et un dosage sanguin de l’acide urique etait realise. Les donnees collectees etaient analysees a l’aide des logiciels SPSS version 18.0 et Epi info version 7. Le test de Chi carre a permis de comparer les variables d’interet entre les deux groupes avec un seuil de significativite P<0,05. RESULTATS. Au total, 95 cas ont ete recrutes soit 60 cas de pre-eclampsie severe et 35 cas d’eclampsie. L’âge <20 ans augmentait le risque d’eclampsie (OR=4,2 ; IC= [1,2-15] ; P=0,0). Le statut matrimonial, la parite, le niveau d’instruction, l’âge gestationnel au moment du diagnostic, le moment de survenue de la maladie par rapport au travail, de meme que le niveau des chiffres tensionnels n’ont pas influence pas de facon significative la survenue des crises convulsives. L’hyperuricemie etait augmentee de facon significative en cas d’eclampsie (OR=3,1 ; IC= [1,2-8,2] ; P=0,001). CONCLUSION. Nous avons pu etablir que l’hyperuricemie etait plus elevee en cas d’eclampsie surtout chez les jeunes femmes. MOTS CLES. Preeclampsie severe, eclampsie, hyperuricemie, crises d’eclampsie, Yaounde, Cameroun.