الفهرس Only 14 pages are availabe for public view
 |  | from | 120 |  |  |
| | | from | 120 | | |
Abstract
Pathological changes of preeclampsia start in the placenta, but
may affect the various body systems including the kidneys, liver,
brain, heart and lungs. One of the most important changes that affects
PIH is hyper plalentosis. Several authors have reported high rates of
serious maternal and perinatal problems such as hepatic rupture, renal
failure, pulmonary oedema, placental abruption and perinatal
asphyxia. Thus, early diagnosis and prompt action are essential to
avoid life-threatening complication.
The diagnosis of hypertension in pregnancy is made by either of
the following criteria:
1. One measurement of diastolic blood pressure equals to or
greater than 110 mmHg.
2. Two consecutive measurements of diastolic blood pressure
equal to or greater than 90 mmHg, four or more hours apart.
Hormonal change in PIH play an important role in pathogenesis
and complications of PIH. For these reasons, this study was planned to
show the level of serum hCG, AFP, E2 and testosterone in PIH
patients compared to healthy pregnant as control subjects to assess if
they have a role in the pathogenesis of PIH.
This study was carried out on 80 subjects (50 pregnant female
with hypertension as patients group 30 healthy pregnant females as
controls) from the hospital of Faculty of Medicine, Obstetric and
Gynecology Department Menoufiya University. They were divided
into four groups according to their clinical data.
Group (A) Gestational hypertension: 15 patients with no history hypertension, oedema or proteinurea.
Group (B) Preeclampsia and eclampsia (toxemia of pregnancy): 10 patients with oedema, proteinurea and no history hypertension.
Group (C) Essential hypertension: 12 patients with history of hypertension, no oedema nor proteinurea,
Group (D) Superimposed hypertension: 13 patients with history of hypertension, oedema and proteinurea.
All of them passed the usual sheet including personal history of illness, past, and menstrual history and parity and history of drugs and diseases including hypertension. •
Finally, blood samples were taken for liver function tests, kidney function test, serum hCG, AFP, E2 and testosterone. Urine samples were collected for total protein measurement.
The results of this study showed that:
-. There was a statistically significant increase in patients group regarding prevalence primigravidity and history of hypertension compared to healthy control group.
- There was a statistically significant increase in age and hypertension in subgroups C and D compared to other subgroups.
- There was a statistically significant increase in patients group regarding ALT, AST, and BUN compared to healthy control. There was a statistically significant increase in total and direct bilirubin in patient subgroups B and D compared to other subgroups.
- There was a statistically significant increase in. serum hCG, AFP and E2 in patients group compared to healthy controls group. - .
- The highest specificity and the highest positive predictive value were for hCG where the highest-sensitivity and the highest negative predictive value were for AFP.
~ In conclusion hCG, AFP and E2 levels increase in PIH, hCG and AFP are sensitive and specific tests they could be used for screening and follow up of pregnant women to detect abnormally increasing levels of them which could be suggestive of the beginning of a pathological condition.