[Serum uric acid levels and risk of developing preeclampsia]. / Niveles de ácido úrico sérico y riesgo de desarrollar preeclampsia.

It is well known that preeclampsia is associated to high uric acid levels, but the clinical assessment of this relationship is still under consideration. Our research was to evaluate if periodic doses of uric acid during pregnancy might help to identify a high risk group prior to the onset of preeclampsia. We conducted a retrospective investigation in 79 primary gestates with normal blood pressure and 79 women with preeclampsia who were assisted at Hospital Nacional Posadas during 2010. Serum uric acid levels, creatininemia, uremia, and proteinuria data from the clinical records of the pregnant women were considered. Uric acid levels were similar in both groups during the first half of gestation. However, as of the 20th week, uric acid increased 1.5-times in preeclamptic women with no changes in creatinine and urea, confirming that these patients had no renal complications. Furthermore, we noted that higher levels of uric acid correlated with low birth weight. We also observed that pregnant women with a family history of hypertension were more likely to develop this condition. Moreover, we did not find a direct relationship with the fetal sex or the appearance of clinical symptoms. The analytical evidence suggests that changes in uric acid concentrations may be due to metabolic alterations at the initial stages of preeclampsia. Therefore, we propose that monitoring levels of uric acid during pregnancy might contribute to the early control of this condition.

Assessing the Role of Uric Acid as a Predictor of Preeclampsia.

We assessed the diagnostic utility of uric acid for the prediction of preeclampsia. An observational prospective approach was carried out during 2014. Preeclamptic women were classified into 4 groups accordingly to the onset of preeclampsia and the presence of intrauterine growth restriction (IUGR). Serum uric acid levels, urea, and creatinine were measured. Receiver operating curves (ROC) of the uric acid levels ratio (UAr) between a dosage before and after the 20th week of gestation were performed. One thousand two hundred and ninety-third pregnant women were enrolled in this study. Eight hundred ten had non-complicated pregnancies, 40 preeclampsia, 33 gestational hypertension, and 20 IUGR without preeclampsia. Uric acid significantly raised after 20 weeks of gestation in women who develop preeclampsia before 34 weeks (Group A) or in those who develop preeclampsia after 37 weeks associated with IUGR (Group C). In women who develop preeclampsia after 34 weeks without IUGR (Groups B and D), uric acid increased after the 30th week of gestation. In all groups, UAr was greater than 1.5. In gestational hypertension, UAr was superior to 1.5 toward the end of gestation, while in IUGR without preeclampsia, the behavior of serum uric acid was similar to non-complicated pregnancies. In all cases, urea and creatinine showed normal values, confirming that patients had no renal compromise. ROC area was 0.918 [95% confidence interval (CI): 0.858-0.979) for the preeclampsia group and 0.955 (95% CI: 0.908-1.000) for Group A. UAr at a cut-off point ≥1.5 had a very low positive predictive value, but a high negative predictive value of 99.5% for preeclampsia and it reached 100% for Group A. Thus, a UAr less than 1.5 may be a helpful parameter with a strong exclusion value and high sensitivity for those women who are not expected to develop preeclampsia. Additionally, this low-cost test would allow for better use of resources in developing countries.

Distribution study of Chlamydia trachomatis genotypes in symptomatic patients in Buenos Aires, Argentina: association between genotype E and neonatal conjunctivitis.

BACKGROUND: Chlamydia trachomatis infections are the most prevalent sexually transmitted bacterial infections in the world. There is scarce data available referring to the distribution of C. trachomatis genotypes in Argentina. The aim of this study was to identify the genotypes of C. trachomatis circulating in the metropolitan area of Buenos Aires (Argentina) associated with ophthalmia neonatorum and genital infections. FINDINGS: From 2001 to 2006, 199 positive samples for C. trachomatis infection from symptomatic adult patients and neonates with ophthalmia neonatorum from two public hospitals were studied. C. trachomatis genotypes were determined by PCR-RFLP of an ompA fragment.Genotype E was the most prevalent regardless of the sample origin (46.3% 57/123 in adults and 72.4% 55/76 in neonates), followed by genotype D (19.5% 24/123) and F (14.6% 18/123) in adults, and G (9.2% 7/76) and D (7.9% 6/76) in neonates. We detected a significantly higher frequency of genotype E (p < 0.001, OR = 3.03 (1.57

Niveles de ácido úrico sérico y riesgo de desarrollar preeclampsia

Si bien se conoce que existe una asociación entre los niveles elevados de ácido úrico y la preeclampsia, el debate sobre su aplicación clínica aún está abierto. Nuestro objetivo fue estudiar la utilidad del dosaje periódico del ácido úrico sérico durante el embarazo para identificar gestantes con mayor riesgo de desarrollar preeclampsia. Realizamos un estudio retrospectivo en gestantes primíparas: 79 normotensas y 79 con preeclampsia atendidas en el Hospital Nacional Posadas durante el año 2010. Se analizaron los niveles séricos de ácido úrico, creatinina y urea, y los datos de proteinuria de las historias clínicas de las mujeres embarazadas. Los niveles de ácido úrico fueron similares en ambos grupos durante la primera mitad de la gestación. Sin embargo, a partir de la semana 20, el ácido úrico se incrementó 1.5 veces en gestantes preeclámpticas, sin cambios en la uremia y creatininemia, descartándose así el compromiso renal. Además, encontramos que niveles más altos de ácido úrico se correlacionaban con bajo peso del recién nacido. También vimos que las gestantes con antecedentes familiares de hipertensión eran más propensas a desarrollar esta condición. Por otro lado, no observamos una relación directa ni con el sexo fetal ni con el tiempo de aparición de los síntomas clínicos. Estos hallazgos sugieren que los cambios en las concentraciones de ácido úrico se deberían a alteraciones en los estadios iniciales de la preeclampsia. Por ello, la monitorización de los niveles del mismo durante el embarazo podría contribuir al abordaje precoz de este desorden gestacional.

It is well known that preeclampsia is associated to high uric acid levels, but the clinical assessment of this relationship is still under consideration. Our research was to evaluate if periodic doses of uric acid during pregnancy might help to identify a high risk group prior to the onset of preeclampsia. We conducted a retrospective investigation in 79 primary gestates with normal blood pressure and 79 women with preeclampsia who were assisted at Hospital Nacional Posadas during 2010. Serum uric acid levels, creatininemia, uremia, and proteinuria data from the clinical records of the pregnant women were considered. Uric acid levels were similar in both groups during the first half of gestation. However, as of the 20th week, uric acid increased 1.5-times in preeclamptic women with no changes in creatinine and urea, confirming that these patients had no renal complications. Furthermore, we noted that higher levels of uric acid correlated with low birth weight. We also observed that pregnant women with a family history of hypertension were more likely to develop this condition. Moreover, we did not find a direct relationship with the fetal sex or the appearance of clinical symptoms. The analytical evidence suggests that changes in uric acid concentrations may be due to metabolic alterations at the initial stages of preeclampsia. Therefore, we propose that monitoring levels of uric acid during pregnancy might contribute to the early control of this condition.