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Preeclampsia-induced Alterations in Liver Enzymes and Creatinine - Pattern of derangement in Enugu, Nigeria

HC Okoye
IA Meka
CJ Okwor


Background: Preeclampsia is a serious complication of pregnancy which contributes to maternal morbidity and mortality globally. It is a multisystem disorder with hematologic and biochemical alterations. Its management
poses several challenges especially in resource-poor countries. Alterations in liver enzymes and renal function are prevalent but varying levels have been reported in different studies somewhat posing some challenges with
diagnostic criteria.
Objectives: To characterize the varying abnormalities of liver enzymes and creatinine among preeclampsia patients in Enugu, Nigeria.
Methods: This was a cross-sectional study involving pregnant women diagnosed with and managed for preeclampsia. Serum levels of creatinine, aspartate transaminase and alanine transaminase were assayed using an automated Chemistry Analyzer. Statistical analysis was done with SPSS version 22. Student's t-test was used to compare the mean differences between severe and mild preeclampsia groups
Results: The study included 45 preeclampsia patients with mean (SD) age 29.1 (5.9) years. Mean (SD) systolic and diastolic blood pressures were 175.7 (21.3) and 112.1 (12.4) mmHg respectively. Mean (SD) values for participants with mild and severe features were: ALT 23.5(6.4) and 35.4 (12.8) IU/L; AST
30.7 (12.3) and 42.1 (12.0) IU/L and creatinine 65.3(9.6) and 9.1 (29.2)μmol/l. All patients with mild features had normal serum creatinine and ALT values. Though some patients with severe features had elevated biomarker levels, none had transaminase levels above the cut-off for severe disease. All analytes showed statistically significant difference between participants with severe and mild features.
Conclusion: Findings in the present study demonstrated varying serum levels of biomarkers which ranged between normal and elevated but none of the patients had transaminase values diagnostic of severe disease. A
review of diagnostic criteria as it pertains to liver transaminases may be considered for the local population to guard against missed detection of patients at risk of preeclampsia.

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