ABSTRACT
A total of Sixty(60) subjects aged 25-40 years were recruited for the study to determine the levels of total protein and lipid profile in pre-eclamptic patients attending antenatal care in Abia State University Teaching Hospital Aba, Abia state. These subjects were divided into two groups of thirty(30) pre-eclamptic women and thirty(30) apparently healthy pregnant women. The result obtained showed that the mean value of maternal age of test (34.03±4.60years) was significantly higher when compared with the apparently healthy pregnant women (30.97±4.80 years) at P<0.05. Also, the result revealed that the mean values of systolic blood pressure (165.47±17.46mmHg) and diastolic blood pressure (118.07±8.60mmHg) of the test group were significantly increased when compared with the mean values of the systolic blood pressure (119.20±3.02mmHg) and diastolic blood pressure (76.99±9.02)of the apparently healthy pregnant women at P<0.05 respectively. The mean value of the maternal weight of the test group (80.55±13.75kg) showed no significant difference when compared with the maternal weight of the control group (73.48±15.70kg) at P>0.05. The result also showed that there was no significant decrease in total protein in pre-eclamptic women with mean value of 57.76±11.36 g/lwhen compared with apparently healthy pregnant women with mean value of 60.86±5.79 at P>0.05. For lipid profile, Total Cholesterol(Tc), Triglyceride(Tg) and Low Density Lipoprotein(LDL) showed a significant increase in Pre-eclampticwomen with mean values of 231.34 ±18.59mg/dl, 162.32±25.46mg/dl and 176.65±27.26mg/dl when compared with the apparently healthy pregnant women with mean values of 201.79±16.63, 84.47±8.69 and 54.18±4.49 mg/dl at P<0.05 respectively. While High Density Lipoprotein(HDL)showed a significant decrease in pre-eclamptic women with mean value of 44.27±4.11 when compared with the apparently healthy pregnant women with mean value of 49.50±7.25 at P<0.05.This findings showed that pre-eclampsiais associated with hyperlipidaemia. Therefore, serum concentrations of lipids and lipoprotein could be used as biochemical markers in pre-eclampsia.
CHAPTER ONE
- INTRODUCTION
Pre-eclampsia has remained a significant public health threat in both developed and developing countries contributing to maternal and perinatal morbidity and mortality globally (Shah et al., 2009; Magee et al., 2014). It is a disorder of pregnancy characterized by the onset of high blood pressure and often a significant amount of protein in the urine (proteinuria), which begins after 20 weeks of pregnancy ((Eiland et al., 2012; Al-Jameil et al., 2014). Blood pressure is said to be high, when it is greater than 140mmHg systolic or 90mmHg diastolic measured at two separate times, more than four hours apart in a woman after 20 weeks of pregnancy (American College of Obstetricians and Gynecologists, 2013). Pre-eclampsia can present as late as 4-6 weeks postpartum. Postpartum pre-eclampsia is the occurrence of hypertension and proteinuria after delivery. Though hypertension is common, it is however, not a universal finding in postpartum pre-eclampsia with proteinuria occurring less often (Mattlys et al., 2004).
Despite being one of the leading causes of the maternal morbidity and mortality, the aetiology and pathogenesis of pre-eclampsia remain to be elucidated. It has been termed the ‘‘disease of theories’’ because of the multiple hypotheses that have been proposed to explain its occurrence(Solomon and Seely, 2004).There is strong evidence that a major cause predisposing a susceptible woman to pre-eclampsia is an abnormally implanted placenta(Al-Jameil et al., 2014; Steegers et al., 2010). The abnormal implantation may stem from the maternal immune system’s response to the placenta, specifically a lack of established immunological tolerance in pregnancy which trigger endothelial dysfunction, thereby evoking cardiovascular diseases such as vasospasm, increased endothelial permeability and activation of thrombogenic mechanisms, and leading to the early events of atherosclerosis (Eiland et al., 2012; Young et al., 2010). Several other factors including genetic, immune, vascular and oxidative stress are also implicated in the pathogenesis of pre-eclampsia (Eiland et al., 2012; Young et al., 2010). Women with pre-eclampsia present arterial lesions at the uteroplacental implantation site. These morphological lesions are usually observed in cases of acute atherosclerosis, and are characterized by areas with fibrinoid necrosis surrounded by lipid-laden macrophages (Ross, 2010). Lipid deposits are also seen in the glomeruli of pre-eclamptic patients, a finding known as glomerular endotheliosis (Airoldi and Weinstein, 2007).
1.1 Justification
Pre-eclampsia has remained a significant public health threat in both developed and developing countries contributing to maternal and perinatal morbidity and mortality globally (Shah et al., 2009; Magee et al., 2014). According to Osungbade and Ige, (2011) the incidence of pre-eclampsia is approximately 2-10% worldwide while in 2014, Al-Jameil et al reported the incidence to be 2-8% globally (Al-Jameil et al., 2014). Studies in the field of cardiovascular research have shown that serum lipids have a direct effect on endothelial function and in this way, abnormal serum lipid profiles are associated with endothelial dysfunction (Sima et al., 2009).
Recent published works have suggested that a maternal pre-disposition to pre-eclampsia may be explained by altered lipid profile, but the reported findings are inconsistent (Enquobahrie et al., 2004; Baksu et al., 2005). Therefore, changes of total protein and lipid profile are worth assessing for in pre-eclamptic patients. This work is therefore, expected to address some of the biochemical dynamics of pre-eclampsia by evaluating the alterations in serum lipid profile and total protein with a view of establishing or validating some of the biochemical under-tones of pre-eclamptic disorder.
1.2 Aims and Objectives
- A) General objective:
To evaluate the levels of total protein and lipid profile in pre-eclamptic patients undergoing antenatal care in Abia State University Teaching Hospital (ABSUTH) Aba, Abia State.
- B) Specific Objectives
1) To determine the levels of total protein in pre-eclamptic women.
2) To determine lipid profile (Total cholesterol (TC), Triglyceride TG), High density lipoprotein–Cholesterol (HDL-C) and Low density lipoprotein -Cholesterol (LDL-C)) levels in pre-eclamptic patients.
3) To compare the levels of total protein and lipid profile in preeclamptic women with the normotensive pregnant women.
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