A COMPARATIVE STUDY OF UREA CREATININE, URIC
ACID CONTENT IN MATERNAL AND CORD BLOOD
OF NORMAL AND TOXAEMIC PREQNANCY AND ITS
SIGNIFICANCE IN RELATION TO FOETAL OUTCOME

THESIS

FOR

MASTtR OF SDBCbRY

(OBSTETRICS & GYNAECOLOGY)

BUNDELKHAND UNIVERSITY
JHANSI (U. P.)

1992

SANGITA KHANNA

ftilA Iji 'to otjrtllfy that tha aoxk aatitlad

&JII..M ,f ■! y I c A y

is t@ certify tliat tha worJc aittit3L«i
"A COMPARATIVE STODY OF UREA, CREaTIRIHE, URIC fCm
COHTINT m MATlWM, AMD CORD 1LCC»0 OF AMO -

TOXAIS4IC FREGNAMaf AND ITS SISGMIFICABCE M RttATJOU TO
foetal OOTCOMl" lililcll is bsing StteitlMNS m s liMHiis
«0* M*S* CC®ST1TRICS AMO GTMAlCOIOOy) fey mu BM mT fX
ICHAMMA hmw hmm eaxsisd oat uii«9Uit wy 4ijp«ct •ncqpNoxvl.siiiwi
m& guMAmtm in ttis of Obototilos and %iiimi.

oolofy, l«*L*a, m&iernl 'Collaga^ ^ansi* 99 mi
•MbodlM la tils mmlm wmm i^jttaicsa % tte mrnmmm
ImmrnM aM cfisaxipatioitsi. iscoidsd ti'ams l 3 s«n psrlodiosiiy
•iMwItesd and vstifisd 'hf as*.

' V.# f -

( MRISOItA KAPOOR )

iitt' ''M'

^ips^ists Pwmrnmwt
of OkRtStfioS
CBf

Ru ■ it« R« iMsfIsapi oolJiSfia

■ 5... f'

I WIMl

■ . . ■' -r • ,. ’ - . 1

iiH

h f I

TMm It. td mrutt <^at tint wagk
•a comparativs wmm of oria* creauikihe, uric ,aci©
commT m mat irral and ; cord si^od of nomal and
»XAW2C wmmpxm and its sioaifiCANCt in rsiation to

FOital OIITOE^II^ nfel*?!! In ImiNO Mil9nittiM!l ayt n tfn if
i©» M,«. CO»STWaiC« AND WNAlCOLOOir) hy DN* SIOWITa

ickanna h«t e«rfi«d mt umdNr diiwiot

liiO omldattes In Hm Daipaftmmt ©f Ob«t#t*4cN and oy g## —

ooln^yif Moftioal Coll,©©## tUnaasA# T!i©

nKbodiifd In mm tNiaia wmm viiti!!*zt«3Mii by tli© cmadMat*

mid ofemtiNAtlOfiNif iM^ojEdatd hanai batmi imm tt y

i 3 mchm&l miA mtliimA hf mm

il« #* ji

ASSOCiatMl

aiisiAN«»«»t Of dUiMucImi

NiPNwr^wp-'itiP ^ ,||| m

tit D* »♦ ,^€ 0 UMi 9 o«

I CO •" 0011*“) '

C 0 «F* SXNOH )

AN^iato wmrntm&t & mmSk

I m * mtm )'

It is with mtk stsis# of gtmtktwBm

that X wish to oaqptfoss siy theohs to mt siost xoirpoctiMSi
ioantoii toachef Fx#f« (Miss) Batna Mitra» M*s»« DGO# FAIMS
and H«a<S DofirnttMiit of Otostotsics and Oynaeeologjfi)

Msdical CoiisQAf Jhansi* was alwajrs available with

ready iovalmabla snggostions and unetiiding oneonragmont
which has played an Ijsportant rola in th(« siaccossful eeiRf>la«*>
tion of the pmsiast volirniiious woxh*

X m gioatly ma^bgbtad to mf gnida Dr* {Mrs«)
Mridala iCaf>o<»r# M«s*t JMisMseiato Professor in the iDsepartmotit
of Obstotrics and <3pMSNBolety» andet wIiotMi able gaidancai,

rirtiifir-itili'iiittii Jv isyk^iiiSOo, ask juasb - Vli^b "f|| ^IjP nBik . jill^ I'ftiii n iAi i ' iMs ii^i'lfc[li-"iiti- iliii liMii -imt iiiiife'tt'fliifiiii itsii. <iilik

IMMiliill Xhtlil^ 1 mWm IUMI %w

out this woxh« iis« Ijuipitatloii fosterod mm greatly t)iroiigli<»
oat the 8tndy»

Z alas owe my siecaxa thanhs to Pr« (Mrs*) Uriha
igaxwal# Aasoelato Professor in tihe ihifastmaiit of '

Ghstatrios iipHiocology and Xhr* d«p« Sini^t
Aasosista ProiosiOt usi MmA <MI tim Qa^artmiaiit of Biocfwmeistrfi^’
iter thoix ipttteiseo in olmeidatlnQ tea mmtimm . of note .

on* In teis aottite niiaiiw wiMbumk teoix ^ i^ifpoxt* tea

I tin# t© tt3C|»x«8s mf Bimsmwm gmtltmSm 1m
mil ttm mmsibexu o£ th® l>epaxtmeii% of Obitt«txic» ««i!! ©sitnio**
eoloff In paftiottlix Dr. Cm«.) Swnit® Axora, M*s.*iwi»oc4arife#
Pi?o£®fisor# 4>*. {Mrs.) S* 3hem«# M.D,, Assistant Pro£«e*ojt
and l»* (Mra») 3. Kbarakwali. Aaaiatant Pzdimnmt fot

thal* «3qp®rt guidanco thtcsogtioot th» coiirs® of study,

X deapiy valu® tli® adyis® and asaiatanco giv®is
toy wy eollaagu®* duxiaig ^is atudy.

X boar in mMmxmcm to ay lady atibjects who toav®
formed th® matorlal fox thi» jstudy.

X also wish to thaoh ixi X^haifii tool wte hm»
iwdttstxlcwialf voxlced in typing thia maimocxiiit*

Iiaatly X wmiM too falling in my auty 1£ 1 do not
mxpxnm my gxatitado towarda my mothox* |»ax«»t*ia*l«ir« and
liiiai»aiid whooo affoctioe, nnexificm and potlaasco toniXd
In mo miffloimat ntmmth t© eomploto thio gigamtio %a«lt
mid to thmftt X olneoxoly dodicato thi» wth of mimi.

I SAiroXTA KIIm^ha )

Satmi •

JL

IKTROD^CyiOif

5fc«a«inia of ptogoaocy is oi»» of tbo moat £on®id*^
atoi® risitg of cliiM b®ar.iisg* tn to i»cxe«»i«ig

iiat«rnal moxbidity and wortality# touaamla of pregnsamcy
is a major factor roaponaibi® for footal loan* 'Xli®

Boverity of disaaa® diroctly affects th® perinatal mox«»
tality* etiology and preventicas of tQita«r.tia of pr^»:
nancy haw attrated the attention of fsany worhers Imt
despite extensive work, it continues to be th© * Obstetrician* a
dilenma* • I

Incidence of pr«**«cljN^sia a rural India varien ^

' i

from 7-10 percent* In general it may be stated that incid«RXX» |
of preeclampaia in developi^ countries is nearly almllaii to [
th® highly industrialised world, but the incidence of aeveiu s

II

varieties is much higher in developing countries due to lack
of antenatal care, :

Toxaemia of pregnancy also contributea to a great '

extent towards foetal wastage, and nearly on® thtjpfi of pre- |

raatuE© birtha of known causes are du» to pre-eclampsia and
eclairipsia* i

i^lsB^aia ia a seriixra obstetric condition whJUdu
ia aaaociated with increased perinatal snorbidity and death*

Moat perinatal deaths are related to prematurity, intrauterJjie

2

gztmth etna abiraiiitlo pl»c«ista«* hm Isirtli

wilght infanta Cpramatnra m&/&t «««11 for gostation)
ara fiigniy amacaptlble to intrapartom bypoxia# tratama
and praaent nmiorooffi naonatal ■ptdb%ma*

Xn tha racant piat« liaimorrhaga* aapaia and
toxMiaia wara iaballad aa most iis^rtant eamaaa of
Katamai daathi «rith t3bm ad'rwat of antibiotic a^ wWei
bettor mmagmient of labour^ airailability of blood trana»
fusion# ha®Morrhage and sepsis do not continue to ba aa
serious a problnn as before# eonsidexable advanea baa
bean made in tha treatsieiit of tcmaasraie with reaultant
reduction in mortality* Howe'wr# mortality continuea to
be high specially when the treatment is not institutional*

ifence# it is appamat £»» tim above that for
the reduction of an overall maternal mortality and impr«re-
ment in maternal health# reliable and easy methods bo
diagnose toxaemias early and if possible# to grade their
severity# is essential.

Hitherto l^e diagrassis was made on conven-
tional trio of edema# hjpert^sim and albumiimiria* At
least two of these three are usually present as a ocMstsiit
ccrspanlon of toxaemia# However# it would be an emiiitpiratioii
to say that aither they are specific or seasitiwe aaoaih to

Tliis Im&S. to AH mmmxitiih fox aohmi

Hostlc value* Cedden and stander (1939) were th® first to
point out that the disturbed phyaiologip during toxaemia
is associated with changes in blood clwwiistry# idiioti whan

i^er of constituMita of blood liavo boma
ixmal and toxaemic petientOf bmt romi ommi
quoatioa eoR^leiMlft tOioogh ootliMitiOMi •!

4

blood urea# non protein nitrogen and nric acid are of
considerable value, Mundel (1930) itatea that blood
uric acid t» increased in normal pregnency idiile Doria
(1924)# stander and Cadden (1939) claimed reductioii,
liowever# Lancet and Fieltor claiffi«Hi that axle acid ie
ii»:xeas«d in cases o£ toxaaoaia. of pregnancy ai»d ie
pcopoxtionate to severity in preeclsuaptic tomsaemla#

It is evident that of pregnancy ia

not always manifested with csonventional triad end in
occasional eases the blood pressure may remain normal
until eclitfipeia supervmaes, 0rea is most important end
prckduct of protein metabolism and depends for its emexe*
tion on adequate renal functiem* Xt is therefore not
surprising that ti'iis product may be raised in blood in
cases of toxacnia of pra^wetcy and its mirial astimatlon
may reflect kidiMijr ftmetion in tcncaemie.

The urea caatMnt of the amniotic fluid has Inmm
I nvestigated by a nisaber of workers in the past who • found
its level in the ■ amniotic fluid to be highor than that of
maternal and cord blood# Hutchison «t al (1962) inveatlgatmi
the distribtttiimi and metabolism of eaxbcm Idballtsd mmm
betmeen maternal and foetal bloods but the transfer to the
•mniotJye fluid was appraciahly aiover* McKay and KUpatricti

»*#**

fanalec*

In aiiOtJhi«3C stady 3t«n<i®i: et al Clf32J stadl«<S
various )ciSti«ir function tftsts in th® ai££«£«iitiatioii &£

tlm tosKaamiiMi of pxmgmrneym Timy studied vatJnus clmmmmem
teats and conciuded that urea clearance^, guanidine and
creatinine excretion testa were of real value in differen-
tiating bettMNtn mild nephritis and siild toxaaniaa of preg*
nancy* They ca^csneeiided the urea clearaH'Ce and cneatixiine
eausxtttion teats for routine use in all cases of toxaemia of
pregnancy# uhere the diagnosis was not clear* A urea clea-
rance below so perciiit of the mean normal and a creatiniiM
eMsretion below 155 mg in the first hour are stmngly indica-
tive of renal demaga*

Stwader# H««l« and Cadden# J«F« (1934) studied
biimsd clMiiiistsy in pre-eclampsia and eclampsia* They

7

flw teiood uxins mM m 9 imcxeasad im m& #£•»

•cleffispsia i»dicatljig « diffl^il 3 «£t€» in it« d»stxr«K;tl«fi in
lives « Thit uxic jusid content in the blood mtqf b« xcgojednA
eg an indicates of gavasity of diaeasa*

Caddao and fassii ( 193 #) atodiad noa |>sotaia
nitso^n# msaa and saat nitsogan in noxnal psagnaat wmmm
at diffasant pasloda of gaatation# dtisiagi labeaut and pmtt
pastm |»aciod« Tliay found that psotain 1^11300000 of
blood daesaagaa dosiiag fisat gin mmth» of pmgmmisf and
than ixicraagad gtaadilf iiotil one oaalc post pastim* Thai
ijucaa nitrogan cemcantsatioa diminished significaiitluf dosing
tha fisgt six monthg and than maintainad a eemstant lavol
until tha althth ©s ninth raontli %diaaa it bagins to siaa* Sbo
ratio of usaa nitsogaa to non piotain nitsogam la dacxiMinod
aignifieantly in pragnaney*

Cadd«a# d* 7 * and Stmadar* atndiad lucic aoM

mataboliam in aclampaia in If If* Thay obaasvad that inesaaoad
blood osie acid in oolimipaia can not bo oxplainad on tho haaia
of docsaaiHMl aaRSitioa by that )eidnaya bocausa inexaaao in blood
nxJiis acid afcMtaxa ms mm of tha aasly aigaa of Wtm diaaaaa
liuixoaa lildaay aooifoataUooa* aoch aa nitsogaoewa satantlMi
aa ahOMi bf tha non psotain aitcogan and msaa valaaa* appaa a
lata Ih tha aoasaa of diaaaMi* t^h blood aria acid ia pnahahly

8

;d«i« to li^fiirtHA Iwpatic da at met too of thia inifib>t«iKNa to
tiMi This topttimftfit to hepatie dostmcticsi of oxto

i|cid appaaxs aairXs’ ft tba diaoasa may pexhapa b« toportaot
to etiology of aelaitgisto*

Ctaislay at al meaamrad tha body water

available for thiocyoata diatribotion i«a«, atctraooitolar
Miter and coocludad that pati^ta Mio aro found to havo
•xicosslvo Bvmllablo wstiir« slthooigh itpporasitly itoxnsl othor«*
wito# ar« procMi to dovolop tbs clsssiesl signs tod spsq^toMo
of pxo-ecla«<psto« Prooelsopsia very asldom appears to those
patients having nortol pxoporticais of avalljiisle weter to lata
pregnancy, iccordtog to then# measmrantot of available watat
is a more reliabla todioe to the danger of developing toxitoato
than, (^ea weight talctog* Patients loose encess aveilahle
totef by the sixth pest portim day*

hancet* h* and Fisher# X*X«» (1956) studied the
value of blood uric acid levels to toxstola of pregnancy

9

hjpttxtmnmlv* both ciawpew^itts i«ir# bigli it

»ii^g«stwd Midamf Aluemm mmml sitaati fimctifiii

tasta ware eaiplOfad,

Von si^ftee eteted in tbe sane leer tliat bieei.
uric acid is as a rule high in tox«e»nia of pxmqnmtxfsm&m
so in eclampsia and nepliritis*

Eanlier Pxi0slmwmtt$ lu reported eleirated

uric acid levels in tencasnia of profmanoj as cosipaxeMi to
normal pregnancy* ^be eoocliided that it gives a fsijr
indication of tha severity of disease*

rNmforin and Roll CitSd) soggststed that higher
ooficentrati<» of ores in amaiotie fluid is doe to its
active transport fron the statemal eonpartMaat Into tls»
smiotlc fluid across Hie chorloaaifiicna*

hassel# h* and Oloris# i* «t al (19SS) reportod
a aeries of renal clear«icea in nounal pragnadoy and fooihd
a aignificant decrease In elearam:®s dtoe to elevated glowo-
mlar filtratiwi rate ^Ich ba^an in first trimester #f
esrly in secwnd trlswister and persisted through the tsmain*
der of prepiency* id»en acrmai pregnancy ie csosi^red with
tORaemis of pregnaney and idMoi aild degrees of to a a is a Bia mm
cospsred with sevsre preeelmspsia wRd eolssq^sle* s direct
relatioaiMp enitted hetweso severity of tow ss is l e . and thai
dspreselon In glonesnlar flltrstlins*

10

Mac Oam^lwy ©t ©1 in-watigatis# tisi cqiiji.-*

lliberetioii of mra* batwean th« aaimiotic fluiJ, ia®t«*sMi3.
md cord biood «ad csonciudad that dlffmaioo of mmm tolai*
plec® thjcougb chofioiiBioiotlc mEtmc® and i« oot Iteitad «o
wueteroal ©xctianga thitcmgli placanta*

Pollali* ViiEip C^960) abi&Afied

rouel bi«^sl©s and otoaeir'WKfli th® ralaticma of hl«i%©2.®®i«
c&sorvaticaia to relation to clinical and blocli«tlc®l flnd-
toca* Ccmblnation of bypertwAsicn,, protatoori® and adoma
iraa found in stoty percent of pattonts with preoclaapaia*

In the patiMta with histolo^ie ewidence of pzooelampaiot

a

thm taiues of urea nitrogon* non protein nitrogon

«Bd uric acid wetxm olairated significaatly ahervo thoso to
healthy pregnancy# Hw preeclamptic renal lealono eom
divided Into three groups on the basis of the never ity of
the glomerular involveoNiiit# Thm levels of mrwa nitrogen non
protein nitrogen and uric ecid to tha serum increased with
ineressing severity of glomerular involvement* Xfi those
patients with mild glomerular lesions# the serum uric acid
was significantly elevated# tdiexeas the urea nitrogen andi
Bcm protein nitrogen levels were signifieantly elevated only
to the presMtce of more aevero r^al leaiiMis* Tims sartai ucl#
acid level is an enoallsnt guide post %o the diagnosis of pro*
oelippsie sad to ihs seeoriW af ^ miderlyhig xansl laalaa

11

{H61) bXwo hiflMii «kxea

i".c<ri’"«nt of thm i‘mniotic fluid in Itt# 0 f

*na that iii toxusada tim uxmm. content vmB hi.gim«t in

tii« uitine of nwboxa obt*lo®d ii«i»d.iat®ly birth* im

fujctiicx i5t®t&d that in to»«rai« ©f th« f©«tmi la

oftfcn in « stat© of tsphyxia# »o that tb# “IntmuteiirwR
rcll'c.'k rctantion of urinatiOB'* i»ay b® distuifc«d in th*
fcptus* In thc-a© circuaRtaace-* a 3.®tg.# mRoufit ©f uma mmf
."ft into arrniotic fluid, rB»ultins in a ri®« of th* ur»®
content of »'»iiotic fluid,

Hutchiisoii at «l (’962) iavoiiticiitad th@
tion nnd mr^toboliar. of c&thmt lol»tll«d uxoa la pxo^oaat
prifflQtoB and concludod that ttMUM viui rapid «ia:hiitt$a of
uxaa botwtan aetarnal and toatsl bloods but tht txansfas
to tha aitmiotic fluid vaa aliMif,

Oupta, P*| Kothati, L.ic* imd- Ciupta# a*l% (1963)
blood uraa and. m,rl« i^id Iwals in noiMl fK»
pt#<gn«Tit pra^ant ^rou^* Xn pra^jnancy coBpXi^atad bf
tojcnswta, uraa w®« wodarataly hi®li in 70 parcont of ctpao
«hil* iirlo acid was re«apicocKsalsr raised in all easca* flm
pxociao Kachaiiion whicli Isadta to aeoaMulatioo of it.xic oa^ii
in blood ia still mneactoin# althoimh l^ptirad tmnl m^em^
dli®iiaialio<l dootnictioo ISf tho livas and
foxoatioo oaaociata^ with amseolar omrtiM Msim cesmii*
•ioiii haao oil boon mofsatoa a# lUiolr poaaibilitioo*

12

(1963) in « study showed that blood nmn
of 5'iother rises with ssverity of tostaurnls, Ms did iwt taJco
into .ircocmt th« possible of gestetlcm# age ©t

parity on area concentration*

Jwaie and Ookhale (1964) st«dif*d the urea elear-
fi'fico test In norwsl pregnancy and tosraemia and they failnS
to detect any difference,

Kc Kay, E* and kilpatrick, S,J, (3964) shov/cd that
ti;e urea concentration in the uabilical venous pla»« ©f warn
toxaemic pregnancies was raised when the birth weight vmm
tselow average for the gestation period i,e, in infsnts show-
ing lUGB* When the effect of gestaticwa period wss r«wov«d,
a significant negative correlatlm was found betwfMsn urea
concentretlon and birth weight, the area cosicentration being
higher in low birth weight.

Xncrease in blood urea in dysmaturity was caused
either by plac«tal insufficiency which prevented the fCMitue
frera excreting its kfp (no® protein nitrogen) threxagh placenta
or by increana in tissua dast«tetioii ©r by both if»cha»iasia*

l»atex an# in 196S# KUpatriek and m Kay studied
untoillcal cord area coficaiitratiim in toxa«iiic pragnancian
and thair relationships with birth laaight and gastational
age. i^hey divided the eases into three groins nwaely ‘honso*
tensive©*# *l' 03 ca«siilc* and 'Other hypertensives* • They foond

13

unrier infant* of tmmot&nsXr^a h&vm a sJjgiiifi-

cf!'r,tly higher mmn urea than thtix follows of ooimal

iR toxnwic wiothors, tl»r« appeared to !>• a raver-*

»ai of the affect of birth weight or cord area l.e# under
wight had a lowr m^m urea concantration. Both hypertaa-
si%’® group* hod higher urea c cnc««itrati©a then normal pxeg-
ndnciee, 'Ahase differences wre independent of birth wi^t
and gestation period. ToxaMsic group had e significantly
lower birth weight than norraotenaive group. Their studiee
suggested that the level of materoal blood presaure is
ffrare important In determining cord urea concentration than
I? gestation nge or birth weight.

Kishore# h« and Tandon« s. (IfdS) studied blood
urea# non protein nitrr^en and serum uric acid and ophthal-
moscopic findings in normal mm pregnant females# healthy
pregnant wcie»n and in pregnancy with toxaemia. T<»a«»mia cases
were divided in four groups, mild and sever© preedlaif^tia,
eclampsia and pregnancy with esa^itlal hypertension. They
caacluded that the level of blood uric ccid can serve as an
importmt diagnostic criterion in tox^mRias* PrognoHls caas
b® told and future line of txm&tmmt can Ise decided by Idna .
levels of blood uric acid* Blood non protein nitrogen was
iwt changed slgnificsntly in cases of tOKawdas of prt:cnaiu:y*

14

..looc ttjrea decreased in normal pjta^nancy, increa#®d in
caffi© to normal, on ai«mt 6th to 3. 0th post
p-irtw. day* tioat common fundal ch«ng« wa® found retinal

Chealey, L.C, (1966) atudiad aodiian retention
In proerlamoai® and made serial estijaation® of exchange-
able sodiwi ®jid peurperial aodium loss and concluded that
oedmatoua tomemic vommn loo»s large amotrht of salt in
the puerperim and that the salt loss is related to tlie
degree of oed«« ai^ its regtesslaai* ^he rational explana-
tion is that in the puerperium* there is a reversal of
chances that occured .in p 3 »gnancyg the salt lorts has been
retainedi during pregnanoy.*

Eastmann and Hllman (1967) also reported a signi-
ficantly reduced urea clearance In toxaemia of pregnancy
when COTnarod to normal pregnancy*

ftfttmn Laitch (1971) ahour^ the lower lewis of
seruia uraa and creatinine in normal pregnant woman conipeiped
v:lt!i non pregnant subject#* It reflects the increaaed glo»e-
nslcx filtration rate in mr»#l natation snd increased rsannl
clcsrcRce* They also shwied n©ic»el iN^rum uric acid in lOiBiiil
precnancy.

15

tfhengh tl» lJicr«a»i in awiiotic: fluid ureu ia
tmtm 1» cowpartwon to nuternal bl<»d uren*

16

Pajrallisl irtai® of iR«tomal and cord blood urea
wca foiffld in toxnoinic casf's compared with normal pregnancy*
niff» in cord blood urea can be due to riae in awiotic flmld
and maternal blood urea levels* Iticreesrd breaJsdown of piD®-*
toina in foetal system may also oontribate towards increaiMi
in cord blood area because in their study the ween birth
wight of the babies bom to tOMiewi'ic mothers was signifi-
cantly lower than the mean birth %j«i^t of tmtiml babies*
Positive correlation of the sdMnlotic fluid urea Itval with
that in maternal and c^rd blood in normal and toraMiilo prag-
nancies suggeots that free diffuai«ft of urea titkes place
between tha three fluids,

Bohtaglf P* and Tewari, K, et al (1973) evaluated
a relationship of liquor urea with placental and foetal weight*
They showed that tlwsre was rise in both blood urea and lii^ioc
urea in toxaeraia cases, but liquor urea increased more ae
compared to bl«MS area* The mean birth weight of babies showed
a si^ificant fall in moderate, severe P*E,T, grew^ end eclisip*
sia group* Placental weight was lowered significantly in ell
groups of tcoe»wia*

Increase of liquor area was negatively eor related
to placental and foetal weight in all the groups od itomssiila
whidh was highly significant to eclaRpsla* !Phsy ooncladed that
rise ihl liqoer area is indicative of placental damage aiNl #ae
’ te pieo^tel dasiege there might be lowering of foetal weight
me well* _ :

acid ctmcentzmtlm xafiactad * dilution* in e&xly pzm^rmtkvrf
followed by a gcadiiai Incxeaaa in t!ui raatarnal uxic acid dn«t

to £o@tal uirlc acid production#

Dunlop# w. and l^viacti# J#M* (1977) atudlad ttwa

pre^wirncf* High nmm c»ac«iitratioi» iis

derfittitc' C0irr«latt©n with th« a«gr«6® o:

urea i«v«I ijQCxessa^ with iac£«as« in th«

M m€ mean birth waight decr«a«e4 with ific
biood mr«« laval# Matansml blood# cord bio

m

20

fm macHDo

Tkm pmmmt »tailir imM mt to mtimmim

th® urtt* ImvXt C3r«atiii4n« iai4 iix4c «eM ia matoiaal

biood ttnd cord blood of aonal pio^iiaat fowalo* mA mom
iufforing fxom toaoiiHoia of «ad imaiilto i» l>otli

bav® beau ccwpaired,

Xsetlnation of th« oxaa lev®!* mixm oxoatiiiinii
and ®«rum uric acid was earxiad out in tli® following gxos^
of £«oal«s t-

1. Haalthy mm^pregiiaiit £e»al«8«

2» Healthy pregnant fesaales*

3, Pregnant females suffering frost l»»Kaeiiiia of pw&gmmmsf#

Por ecmnuienese toxmmtm of pregnancy eesee wem
divided into three grmips depending upon ttwi severity off
tihte disease. Three peraneters were considered l.e* bloedi
pressure* oedema and pi^teinuria*

GROUP A I (mid and moderate p»s-ecloR5>sia)

Tho«(» caeas in which the blood pressure wee
detected upto IfO/lOO m of Hg with deteoti^le CMMtaia eiti

^ 3A w * *41 it

21

In Isiocd px^snux® iM« xalmS i^cmt

160/100 sun of Hg with o®d«®tta mM/ox altoiwiiiMrla*

QliWP c I (Selin^aiii)

Th«a« patiants pxammtiid with waxyizig dagsmi
of liipN»irt««ijii€ait chi4«mg« pxoteinaxia with coowolaloiis*

ttwi hoalthy nm’^mgmnt fwtialas war* 8*l*ot*€
among thOM attaiMSing th* oot patiants AopartaiMiit ' Ia
O bBt*tric» and Gynaacology# Madical Coll«g«,dh®is#4

bet?i««n April 1990 to March 199 1« and thoiwi adteitt»d in
ward for gynaacological prohloas* Ih* normal pre^^ant
fomaltta ware aelactad amcmg thoa* admitted in Hel^imitif
Ward and Lateur Rooms during tha same period in some hCHt*
pitalf in last trlmes^r of pregnancf* preferablisr within
fifteen days precaeding the ^liwary. The cases of tcmaamim
of pregnancy ware those admitted in tha hoapital in the
third trimester of pregnancy near teiei.

In all these eases a detailed past aM present
obstetric history was taken* A thorough general soceeiliiatlJMi*
systemic and obstetric eacsminaticm was done to note the
period of gestation* presenting part* its posltimi and
mmrngmmnt* fCMital heart was auscultated* Hood pmmmm
wee recorded in ei^h patimst*

22

lirtli Wight of th« h^hios boni to tint
•ct2"«r» £i!Coi:d«s!l in gxmmm

1* ite«ji(^l©hiii ootlnaticm.

2 * Albomiti in urin* by boiil^ to«t,

3- lOtlmation of nrw lewi in nuittxiioi blcKwi ioimI

cord blood,

4, Eatii^ation of omtiainn Uml in untnninl blood
and co£d blood.

5, BatlHirtlon of uric acid lawl in siataxaal blood
and cond blocd*

Collocticm of

'It *

.11 pod Qgaa - Matornal blood was collactad in an oocolato
vial from the antacubital win of the salactad casan*

The ainouiit of blood taken was 2 ml.

Cord blood was taken at the tiiaa of deli-very fitni
the baby* s cord in an oxalata vial maasnring 1 «1*

■Se.roa . creat joint * 3 lal of raatamal blood an

wail aa cord blcNsd were talwin separately in plain vial*,

Mryiii... uric acid * Arowd 3 »I of natamal blood asMi
cord blood was taken in' two miparate plain viala.

fiitlniatioti of tiraa level in maternal and cord
blood was dona by Hesslarisation method aa daaesibed by
King and noottan# 19S9,

23

g-giacipl# t

Ttm mml* M hlm& Im ^ wemm and

«i© mnii i« tutu emmttmA iuto Mtmw tiMmil. ®f

th« prot«i«*, tli» ht tTcm mmmim wim

Mma»lmx* » jctagwQt lit e«ai^EUi»d iri^ tlu coiotu: pvoteud
iiad«r tlmiUltt with a^mSmxA mmm •tlaticm tmmtmA

with Diiwct ShNisittitiitiai tlicmid not XmA t® pt®**

^tiim ®f eiotidiiMst i» thtt emm of ^£ot«i» f m fiittotoo
fxcmt th« ooiidiod blood*

sulph^^xyl tmhuttMmmm, glotathioito a»d oxgo*
thicmin® which pzod®e» tujdJiditY with. li««iil®x* » mmgm%
bocause of isii®lubility of thoix mezoory awlt# az® coo*
finad to the cells aisd do oet appeax io the filtrate# with
laKed blood, Filtrate# of uolahed blood havm further advan-
tage that no awncmla i# contributed to the determination,
through the action of arginase of the blood cell# m tNl
arginine contained .in the comereial preparation of umtaso*
The uae of nine hydrcecide a# deproteiniaing reagent olMiv
nates the oaall aoount of turbidity producing ind^ataniio#
contributed by iRost pioparationa of urease,

»

Ca) l^gt * Qml mX of blood i# added to a centrifuge
containiiig 4,5 ml of isolmmie sodirm sulfate solution, 0«1
ml of mzssse solution is added and the tube is stoppoxod
vith s srdibor lining* mijoed and incideiated at Sl^C fot JKI

24

wa of sine mOM*^ m& 0*2 nX of 0*$ It
•oaiiM tt^rOjcoseiA* «f« »&&&& to pml|»itAto tho piotoifiii*.
The mibctem in imXX tkiieed tr^f immx»Um msM eontsifOdoS*
3 ml of »iiqpejaitttaiit fluM Ci.Q# mi of Isiooi) i# ' tjw«t«€
with 2 ml of iMMiiie £xmm dietillod mtitmx# 0»9S ml !««•
e drop of lodiiie ooiotioa (topxovmot oXomiiog) mod i ml
of Me«»l«x*s mmgmt*

#> 4*S mi of lootamie 'aoiotion in e
tube eoMl 0«1 ml of etendaxd msiimtloii le edded*

• 4.5 »1 of Ijtotoeic solution. 1 al of

xeagtnt is «dd«HS to each tube a»d xeediegs ase tekeo egeimmli
blank using blue flltex (480 nm) *

£al.satesi5B >

Blo<^ uzea X 100

(mg/100 ml) stBje®iraiaB«aing • Blanlc xeeoitig ^

Pxinciole » Cxeetiniae is t.cestid wiidi picxic meld Im
elKalixm medium* glares a xsd colcnu; which is meeinjiKed
eoloximetricelly. The xemction is celled Je€fey*s xeeetiimi*
The method used is modified -vexsdon of Bred et el«

amer ent i

1* ■ Sodium tingstate* 10 paircent
2* lAslptiuxie acid ( 3 / 3 )

3* Sodiim tijrdxoacide 0*1@ pexcent
4» Sate^ted pimxim acid eoluticmi

25

S« Sfeoclc $m isi'itiqjMis®# fey

too mf of p%m diy cjMwittnii^ in tm ml ȣ O.I H ttel,

woiilciog mtmMmxd - OUmto 1 ml of stock

to too »ll Witll VStSJf*

7m iH-lMillwi litesmfei •ol.mtioii is putpsrsfd Jmst fee£o»i uso-
ie 111 sstiumtsA pimtis wsM md 2 ml S«OH»

£.£S!FMEiSg. >

- In a eetitrifmpi tiafeo I mX saxusit 4 lal 'of imtos sad
0*5 ml sodim ^logstafet 4»id 0*5 ml sulpha xic acid is rnixod*
The mixture is inverted and centrifuged. 3 lal of at^*3aatiai%
is taken in another tufee.

Sta.ndard - 3 ml of sorking standard creatinine.

Blank ~ 3 ml of water is taken.

1.5 ml alkaline picrate solution is added to each
tube and contents are misted well and left for 10 minates*
now the absorbance is measured using green filter (S20 tmi
against the blank.

gjlsAtitoi >

Serum crsatlnine ^st reMinq „ u '

(mg/iOO ttl) ^

Mxm. s

Prlnci'ple • Vtie acid Is treated with phospliotiiiigstie acJMI
in alkaline mediiaa. Phosi^iotangstic acid is rednced fey uri«
acid fostting a felee eolimied esoi^lex idiicdi is nsasassA

!• Protsla pieveiiiitiijit «• 50 eil ei ccHiittK 'Imgf'ji1sals<i«

$0 na. «f£ a/3 ^ miilpimxixt mUL « Oiipe^ ef
miA Is wbHid in 800 »!. c»f wktmx»

2. f*1^s|)lKHisa8gsitie seiUI
)« Sodiiom ««i9Mai!4it» 20
4 « 3i:«»c1c arie aciO stamiaK^

5* Worlclng uric a^ld steeMitaxO is pt»p%tmA 1»f Oiiutiaif
% ml of stock stftiidsrd to 200 ml with mtmr*

Test - I» a centrifu^ tub© S*4 ml of protaia pr«ciplt«flit
soltttioa is taksa and 0*6 mi of mvm is added to it* 2t is
mixed well and centrifuged* 3 ml of sui^matent is tataa ia
another ttibe.

Stai^ard «• 3 ml of working standard is taken in a test tube*
Blank - 3 ml of «mtsr*

O.i ml sodiiMt carbonate solution and 0*6 ml c<
phosphotungstic acid is edded to each tulxn* mixed and plmeed.
in a water bath at 25^C for 30 minutsis*

Bow absosbance ia measured within 15 laliiiitMi
using red filter iss> against blanib

CaXmlatiOB •

sextas uric iwsid ^ Tmt.... reading v &

(ag/lOO *1) “ iiSaSil jwHSi * *

27

B 8 1 R y A1P I Q « S

In mu pttta«iit study, t hmm ©stlmatsd hlmA
ttwws mxwm cpistiaisw «ad s«sm uxie scid in 25 nuii
prspisiit Iwtalthf f«»ai«s, *PlMis« cases 'wat# saiactad
amiMog tlv« fsnaias attaadiiiQ tlwi cat patiatit dspartawoit
of otostetxict m& %iiaiic©ioiy* K.L,B. Hadical Collar,
dliansi*

Blood aces, seioa etaatinlna and sainira larlc
acid levels have been «ati»ated in siatexnal blood and
coxd blood of 2S l^althy pxegijant females admitted In
maternity ward and labour room In M.btB* Medical College,
dbansi*

44 patiimts of tooeaeraia of pregnancy we^^ seleelMd
fSMR the ateitted patients and maternal blood area, serom
orlc acid and cnaatinlne aid in cord blood also, were estl»
mated in each case* The birth weight of tbs babies born bo
fd^ove group of pregnant females wece estimated*

The following are the detail# of observations i-

§liaod..m..>a*. aeraii crefetinfaie.._,and:.airim...mrio mM M mxml

ftjjMtejg, Imilii *

Td»le Ho*! shows the rmsge of blood area, san»
sreatlnine and sefom mrio acid in no® pragnant healtt^

Tim Islood ia te«elthy non

ron^od from 18-33 mg/lOO ml with a imm vain* o£ 25*86 mg/
100 ml + 4*43 s*D. to find ont tb« *ff«ct of «g« m blood
ur«a l«vetl» in normal healtby non prognant f<wa«l*», ■ tte
ca»«s w«r* aividod In variona ago grwq^* Sabi* No. 2 Bh&m
th« blood nroa level* in diff®r«it ag* fioiip* ©£ nonmil
healthy neoi pregnant fetaalea*

TABLE NO> 2

Shotting blcH>d urea# in various ago gronpa in normal
healthy non pregnant ^Nimalea*

Age group
(in year*)

Ho.of

case*

Percentage

teif«

Mfi Xl^,li|.JllL.
Mean s*D*

16-25

8

32

18-30

25.25 t 4.00

14

Si

18-33

26.07 ♦ 4*f 1

36-45

3

12

22-30

26,30+5.1®

statiatieal analyaie e£ ibove data van done and
p valnea calcmlated beteean age grcaips were more '<^aii dmdS
between TOy two gfonpe Age haa no effect mi blood niBen

HwlrliiJIe

29

Cfftatittia# ia li«aithy nm

f«al«s xmgmd ttm 0,6 rag/lOO ml t© 1*5 mg/lOO ml with
fi rooan vain* of 1,04 mg/lOO mi t Q,2t s,D.

To find oat tiai affact of ago on soxwa croatiniiMi
iewala in nonnal hoaithf mm pscospant fimiaiaa ’Wm ernmm w«r«
diiriiSad In 'wmtims ago Tablo Ho* 3 ahowa tho aaicom

cjToatiniiMi lavala in MMimxmt msm gtoapa of Htowal healthy
ficaj pregnant feaales.

TABLE %

Showing seinia cseatlniiMi in varioaa age gifowps in
normal healthy non pregnaat femalee,

hge group Ho.of Percea- ,ail3g

(in yearej caoaa tag* Haage Mean S,D*

16»25

8

32

0*S- 1*5

1.04 *

0*28

2i«-35

14

58

0,8- 1,5

X

0*23

3®-4S

3

12

OiiS** iflO

0,93 ^

0.15

statiatical analysis of abova data was dona and
p values calculatad batwa«a age gio^e^a %Mir# mom than 0*0S
hatwaan any two 9 ro«|?a# i*a* no significant dlfforanca
aicists batMaan two gcmps*

^

Vtm mmm msie acid In pragriant

females ranged frow 2# 6.** 4*2 si^/lQO ml witii a mean
I'slu* of 3*28 ing/lOO ml ♦ 0,51 S*D.

to find ont tlie affect of age on blood nree
level® in normal bealtby nm pregnant fewalee tbe eeiwie
were divided Ijato vafioa* age gronpa. table Mo# 4 ebowe
th» aeriaa uric acid level* in different age group® of
normal healthy non pregnant female*.

m. 4

Showing serum nzie aoid in various mge groups in
normal healtihy non pregnant females#

^ge group
(in years)

Mo #01
cases

forcan- ,
tags

,__Sa*im. _ttrie acid Cec/lOO ml)

'iahge

Heah

S#D.

l§*2S

•

32

2#@ - 4*2

3# 20

0.67

2i«3S

14

§6

2.6 - 4#0

3*21

mm

0.52

36-45

3

12

3#0 - 4#2

3#73

0*67

Statisticel analysis of the above date* mm doe*
and p valuoa calcnlatod batwean various ago g**wj|»* i* more
than 0*OS i»4i« the differeacee are not algiiiflewit.

31

. ItDtil'i* P>BiW aad smmm aric acM

n0CT>»I .mmn^ ticy ,

'Owi* iMmXa^ s«xim «jtemtialaii anS ihixw mri«
acid in nat«xiMii bioodi sM cnisd blc«id wad tlwi biattli
of tho babltts bo wo to nomii pjcogsaiiot

ic»«io8 haa boon ihown in TabX*

Tim blood mioo loimls 'in UMitofiiaX blood tn
noxBal pxmgmmt fcnalaa in pf#«*nt aories f«a®Bd fron
14 to 28 ng/lOQ «1 with « nean valim of 20*C^ ng/lOO ml
♦ 4.84 S.D*

Tbo grispb So.l gtmm tba blood m.mm IowbI* i»

25 pro^ant ©nd 25 pro^nent fwaalos.

thm foim ereatinina XmmXtt in ffiatomal blociMi
in nosnal pnagnant fiamalas raagad Iwcm 0*5 mg • 2.8 ws/
loo ml with ft aiftftn wain* of 1.26 mg/100 ml .t, 0.44 S.D#

Tbft Offtpdi Ho. 2 fthomi tht iosim oHftfttiniXMi Imwolm
in non psogaftfit tad pi:«ga«iit femalft*.

•Sm ftoxim itxic aoid Invols in mtftxnal Mood
xangod ffon 2*5 -* 4*2 ag/lO© ml witti ii mwt mftlmft «f 3.2t
mg/100 ml 0.48 S.D*

Tim 8X«^ 80*2 Itewft ^ ftoxnii mxle imsid lUmilft
In mm pxmvbant and oosiMil pxaimifit fanalos.

til® ®taaiisia

mn t • p«x4ty mA blood 'wemm

croatlnlne and utlc acid*

^^.ABLE f

®***rf®® blood lisia. attx^H m

rt»a craatiain* mA mmm axie

•cw la OUteiimt pul*, 9*<si^,.

H©*©£ Pur.

caaag ewi*
tag®

Mataaiai
blood aoaa

rntmm&l Matomai
iMiiMiB aoxaM
cxoatiain® aric fteid

♦, Sffl wcaa ♦ 3

If.i ♦ 3,2-r l*os *0^38 3*1840,57

4,43 l*10j^0«42 3#Jl%@*4«

i7.37;t 2«4i 1,S3 ♦i3.4S 3*S:M,4«

41*,# C*lC)BLlat#d
Of* tbaa Q«0I
.oaifiosat dif j^xoaco

Fe£iod

of

tatioQ

Mean •«> SJD

l•a]l t ii

if*f 2 ♦ 4«{M l*i? 0«ii
it*it ♦ a*n i*rr ♦ ®.i*

Tli» mxum ematixiiMim ia

dull. v« 24## Eaii 9 @d fEOBft Q*s «. 2*2 i
Valutt of 1,26 III04 0,40 S,D*

Thm mmm m*lc i^iid In cord telood of Mnaol
dollverlec. ranged from 2,6 - 4.0 mg/lOO mi with a mean
ireloe of 3,34 m0i ♦ ©,41 s,D,

The cA>tai»ed date wee farther eleesifl^ on

The ciwparleon of cord area, creatinine and
in in>ffiiel pregnancy and toxaemia pregnancy
epicted in Qr^h »o, l* a and t nai^rectieelf

Cef 4 him^ Coipa Cosjfl aMiXiW

Skicming relatJUmihip of gestaticmal ag« and ccurd blood
uMta, craatljaiae and mxic acid in normal pxfignaiiOY*

Cofd blood Coxd aarom Cord Bmmm

wmk eittatiaina Wmie acid

Kai» ♦' m

Nian ♦ SD

On atatiatical analyala of abowi data# «*>
dlffaxma waa foaad to aidat batna^i mr tm
Mia aliwi^i w»Mi tbaa 0*OS) i*a* pstity m& faatatioawlil.
» 80 ofl^ m eotd blood mOrntt*

18 ,©6 ♦

l.2f

♦ 0.40

3*30 X 0*3^

18.75 £

3.55

1.24

♦0.40

3.29 1 0.48

17.50 ♦

2.07

1.27

Z 0*22

3*47 ♦ 0*23

37

Pinwamaacy ,

creatinine and uric acid levels to »atem«l
*nnc. cord blood was estimated In 44 cases of toxaemia ©f
prsignaney. For the lAirpose of detailed study these cases
%;ere divided into three groups*

uroup * A» - Mild to federate preeclampaia 22 eases

Group *B* - Severe preeclwipaia I© cases

Group *C* • Eclaas^sia 12 ‘'C O' 9'''^ l9

Th» urea# ereatiniii# ai^ uric acid levels in
Katemal and cord blood and ttm birth weight of' the infants
born to above groups has been represented in Tdble Ko# 11.

®ible Ko* 12 show# age and parity wise dlstribu-
ti<m of cases of bsxwwBia of prepiancy,

12 ... ..

aiowlng ago group and parity distribution in tonosmia of

ivge group

In years)

Mo.Of

jmm mum, m

Per*“

cen-

tage

ljSLiifey._..„

Pxlolpsra'

vocoiid

pars

' lore'

secfand pmm

as

S4»@

ti

4

1

2M§

19

43»2

4

$

7

Totei

44

a©

U

19

FeifsiHitsgo •

4S*9%

$i»m

22*7%

, ^ oi pemfmmf it sioio tCMMSi

M mm IIM9 i#»ii fttxt#

3S

Vtmm. CwtteiBB ana

Blood aojroia cfeaifeiaiaio and smx*m nrle

acid Icvol was ®»ti»at®d In 44 eaa«s of toata^mia of j»*of<**
naiicy 'which included 22 case® of mild ito raodajcat® picooclawp*
oi« and 10 c®««« of aovare prceclampaia and 12 cases of
•claanpsla.

Table Ho, I3 abows tlialie Agttmxmt level* in
maternal blood in different deereea of tcmaemia*

Sboififig blood Urea* Creatinine m& Uric acid level* in
different degree* of toxa«nia.

Toxaemia of Ho,of
pregnancy cane*

Mean blood
nrea

Mean ♦ SD

Mean seiraii
creatinine

Mean ±. S0

Mean sexi*i
mrie acUi

iRs/?,saj|U

.« PET

le

22

24*71

♦

mm

4*24

1*55

0*34

3*47 i 0*fl

li

•

33

, JL H 0 e»

2.4

2*0 - i#d

Pf^

19

30*10

2.51

1*®$

0*43

4*14 * 0*9d

\m

34

-

34

1,2 *•

2*5

2*0 •* $#2

lia

12

35*17

i.

4,93

2*52 ♦

0*96

4*70 ^ 0*99

2B 41

1*2 - 2»S

3*1 ^ ••«

fba atatlatieal enalysla of tlw *ib«nai data mm dMM
mmm l» fabla iM»« If# 19 d tl# Gstffi sa* 4# 9 & i mmm
eaafMxljNMi #i mmm$ mmmimim and mtin acid In

w ipii M.!^Pvp w apaiii e*aFaiPwPip*»wpsep^

39

mA MMle acifl Imili .te

.,. of pregi^ancy ,

Tafcle Kio* 14 x»ptaemt» emx& b3loo«i ummt
cx«atiiiin« miinxlc acid ccmc«tjratioa in dl£f«i»at
degff»®8 of t«m®«!nia of p*ogiiaiicy»

fAELE m. U

ahotring .urea*, creatinine and oric acid Icfola in cord

to d«g.goo» mi toxaemia of p£0<3K.aiicy

ToxMsnia of
pregnancy

■HO.Of

cases

Cord blood
urea .

Cm/iQO ml)

Cord a® mm
creatinine

„,4pg/M0 _p|l_ .

Cord sernm
uric acid

|lBp/1.0.0 Mil.

Mean

i

Mean SD

Moan X

Mild to

22

24*16

t 4.53

1.47 ^ 0.34

3.37 ♦ 0.49

moderate PET

Range

IS

- 33

0*9 • 2.0

2.0 * 4.2

Severe Pi-.T

10

29.20

t 2.86

1.79 t 0.40

3*93 ♦ 0*74

Rang®

24

* 34

1.0 - 2*5 ■

3.2 - 5.2

Scian^sia

12

34*42

t 4*62

2*55 X

•»§1 X

Range

28

•■42

1.2 - 5.0

2#® ^ 5ii®

StatiKticiO. a»*ly*i« of aboiro data tias b«HW» glMiiHi
in Tabi« lio* 18» 20 and 22 and tboix conperiton baa hmm
depleted in Giapb Eio* 4* S lotid

40

;gsB.a.oj

Birth nai^t x«cordeNfi in 44 ca&mm of tO'atiwmla
of pregnancy iji present aeries. These inciuaed n bihiea
1^0 remained elii», ^ ibabie® iiiho died within 4 i liottra
after birth end 6 toehie® who were still bom*

lor porpoae ©f ©orrelating birth weight with
mw& blood area, tl» birth weight was divided in four groiipi
and mean cord blood area, creatinine and aric acid in eaih
group aatlmatad. This ia lepreaanted In Tible ho* It and
Graih Ho* 7 and Sji .

mieifiiig relation of birth weight to geatatioaal age#
cord area# cseatiniini and aric acid lavela in t»xa«nia«

Birth llo*«e mm cord blood Cord mtvm Cord aeroM
wiiglit casoa Qaat. area creatinine arie acid

cgme) ^ M

(in wlea>llaan ^ SD Mean ♦, SB mmm t s©

l»<IO«tt®0 10 Ii»2

41

Wwm ^ it em hm mmn tliat

th» feirtb vmlght @f imitmtm beisii to thm tmmmim iwotbor
are not rolatf'd to period of gestation.

Sbe biith weigtit lias! inTOrse reletionsbip %ritli
cord blood irrea* cord blood mrea increases wildit de-
creese in birth iiwii^t and ttsi increase i» statistically
sifieiificaiit.

Shmtimgt bir^ weight in differant grades of tcmaeinie

sevarity of

ho.of

Birth weiobt __{!« cp»s,)

toxaemia

cases

mid to

22

2400 • 3200

2tS0 t 220

moderate PIS

^Jevare PST

10

1000 « ^00

2380 ^ 326

beliaapsia

12

1000 «* 2400

2060 3SS

On etetisticel enelysie of sdMnre datSir follcerin#
revolts were femd t-

BetiiiNirn nild
VMdierate and

PIT

t • 3*iC»

Between nild PlX t e 7*12
ana eexanpisiji

Between severe PE7 t • 2«20
wid eelanfsie

p leas than 0*01
sigaifioant

Si

less then 0«00t
.g^ly si^^flrant

p less than Q»0S

sigaificant

2t shows fioie fihle no* 1$ and on^ wo*]# that
birth woiglit of the new bom decreases signifidsntlf ss
the severity o* towwnis increases.

♦ SD

c«ae« (wa%)

F*«gn«iiey

Mild and modaxata
PST

Suit L«s« tlbm
0*01

2* l^mal pgm

smmm Pm

#*1S Laaa aiMm
0*001

3 * Ma»ai pn

iclti^aia

0*8® l*4iaa %t!um

0*001 hi*MW

jMb' W dflTlIllli^'iliiii mm- M JHA'

m A * Jt€s

4* Mild aiid modaxata
PET

®avaxa pm

I*®? I<a@a tlutii
0*001

'nJte' mI' iijgiiiff ,riH’ JH ii^' III II I 'MM' I ililili'i

aa^l.sS 0 iMI

S* Mild and nodexata
PET

Delampaia

i«iO l»a«a ttum
0*001

2*04 Lass tlMm
0*01

4 i # i iP» aai

43

Tj^>BLE KO.

ahowlxig ccKRperiitoii of motornal croatinin# butwoon

nomol prognaocy and diffaront dmqxma of toxtta«ia.

ai# Croopa ©f
lo« caaaa

ISo.of nmm sD t vnlm p valpo
casaa

Homal pragnancy

as

i*2S ♦ Q.44

2.48

lM»» ttiaxi

o.os

Mild iBd Modaxata

Jr fi

ft

t*S5 ^

aigoificaiili

Momal piagfiawey*

as

l»ii2S ®it44

3*S@

I«asa titan
0.001

Saaaxa PET

to

l*i5 i. 0*43

aignifieaiilt

Monal pxagaaney

as

^ 0#44

S.SS

h®m tlutt
0*001 liigMir

iiMHuwiiii'w npi awiliWiiBWyF

12

a.sa X. ^•ts

..au^.A ...adwaaan 'Jft JUf Jl

IP

ni^JLQ a^KXUllfll

w m-m

aa

a.SS t ©.34

2*14

XfOsa tliaii
o.os

teiMJift WWt

tpip j^ppipi'

m

a.SS ^ 0.43

aaaaxa PIT

to

l.SS ♦ 0.43

2.09

liaaa lOaa

o.oi

BcJLiMpisJyi '

at

a.ta ^ o*f $

itigailiiMiiiiiO

inSMam ##

umz§*m

4*40

lt#a.a

<||IWiS*’lPP'!'PPP^pPF ,,

MtJItMpilliyi

ta

' a*is t

0*001 iiigiisif'

44

-MW

Jho,rtn, o«p.rt«« Of nowmi

P«9»iii>cy nd aiffOnmt ««»•• of

Ba. o*o«|^ of

1# H©»«1 |^l»gB«nef

2J1<1 am

FIT

2« loxtiiail. pwat^j^BoMttf

mmm pwe

3* loisici FiMigit«ii<e3f
BelmiiAiii

4* MM wid i MNi li n t ii

PW

****^111* iiw idii mik

mFWWjm Wmt

S« 8&w9va F®p

j||ii||m|i jii i| mt

C* Mid aai wiviMNi

Fll^

liltmoMli

Ko*0d

CSliHlS

**»«a ■#> SB

2S

i*2§ ♦ 0*4®

IS

i*47 X ^*n

ts

»*a® ♦ 0*4®

It

i*i4 @*i®

ti

l«3f ♦ 0«4i

it

4*1© ♦ 0.031

tt

*•4? ♦ o.fi

it

4*14 X ®*®#

it

4*14 ♦ 0,S«

it

4#tt X 0*®1

m

3.4f X 0*m

'tiPWlF

4#tt X t*»l

Mi

t mXm p mXxm

!•§§

Miw ®lii»
0»t® »»%
•IfMfMwi®

i«si

LmBB thma
t»tti MgMf
MoMf iim®

«.7i

!.«•» tltM
0*001 hiitilf
•MilifMtfit

t«40

Mss tliiii
0«OS

S34PlJ.£iC4ild|

I.St

Hose tliwi
©tOS 0CMI

4*M

ZtBm tlMi

t*tM

»o*©£ SD t 'fall** p imtm

I« Konal pxmg^mas 2S

MIM a»d aloitesvito 22
WWS

2*^ IniiMi 'ttltaMa

0»QOi M$lk2f

•iigpl f ' l

2* l^oxifial piragaane^f 2$

mmm ww iO

S*4S Miss l^an

o»^l Mfhit

S*i0 Mss %liaM
O«O0t

siiisifiimii

3«22 Mss

0,01

wm iflc iIIh ,J|iLb

•iipHiX UPMIIIi

i*0i Mss tl»MI

0«001 li|<g|^l2f

li ■ ^.M

9 A vwPPit

#• * *i| S nB^t WSiSSSlHI 22

ttSW*

%M 94,42 t 4,f2

Bo.of mm ♦ SD % mlnm

1* Hoimiil i»i«pii«ief 2S

Mild m& m&ammrn %t

wm

i•9S l^is

S«©i tolHt

Stfnnpi

i«iA £4I«8 uSmm

0«00i hi#iif
•ig»ificriKii%

3. nonal. p«»f[iaiief tS i,2$ ♦ 0t40

lelHi^iit 13 3«iS ♦ Q*S1

6»Si hmm tliitt
@•001

aigiiifieimt

3«34 tmmm tmm
©•©S

2«l^ l^ess tti«n
©•©$

'iilllk''il M, tilt ■'M

aS jmp4K

22

filKWiag ccR^wjciUMi pg cpw& bl©©€ mric «cM batMWKCi
aoxmal pgMgamcf mid Aiffmmnt dmgxmp o£ tox®«mia*

Oxoupa of

Ho* emm»

»o*o£

Mpm ♦ SO

(m0%)

t Ottilia

P wttXwp

Im Mtosiml pxoQiiaiiiey

29

3*34 ♦0*41

0.23

Mom tlimi

0.09 mot

Mild afid raodoxato
WET

22

3.3? ♦ Q»49

sigaifiemtO

2« HoxsmiI pxmguamsf

29

3.34 ♦ 0.41

3«0S

thm

0.01

smmxm P &

%@

3.03 ♦ ©*?4

3* Mozmal px«<gnmief

29

3.34 * 0.41

s.to

S^ss tMmi
0*001 Mfhls

lelanpaia

12

4 .€3 ♦ 0.??

•ignificanll;

4* Mild and modoxato
PET

22

3.3? Z

2»5i

i«88 ttiim
0.05

9»V«IX« PIT

16

s.fi ♦ 0.?4

•ifpifitMlt

9* mid wadaindMi

PIT

22

3.3? ♦ 0*40

S*®3

L9m§ thm
0.001 liiolilf’

12

4*$| z 0*?*^

iH^fi I.S xlSwill

#• s&mm PST

10

I*t3 Z 0*t4

Ji diii

z^»M n^m
o.oi

Jh j| .ii^ M jtfeifcL

Ip

iBrliiiipali

12

4*«i X

48

Btttaai l IBfl tOttll nott«IltY la tBx«Mil«« :

In tl^ pr®s*nit 8eixi«iii af 44 eattts of ta!Ka«mi«
of piB^nancYf Hi&lMiitnal fiiMafih oc;c®.j»4l JLb Iswo caaNiSi® ®Kf
©clmnpaia and 13 tmw horn infanta died whicti inclndad i
ntill 'boms*

II,

Shoering axoa* eneatinine s^ nric acid lamia in mntmm&t
blood in tno oaeon of maternal doaidis*

Variablo

Blood

Moan

SiiirtMjt

Mean

' Sexwa

l^.aii

mnea

im/

omatinimr iwm/

otic acid im/

im/ ,

loomi)

Ca^lOtel)

lOtall

img/

lOOmll

lOtel)

iOCbtl)

i

40

41

$

#3*

d

S

2

41

!•§

4

to meti^lisli tbft melatioiiehip batMaaei toed blood
emliioa m& lfif«at movtalitf fbe tmsiooe tml«ee is oo»i blood
haifo boon OdbeHotod in tablo do* t4*

49

avowing -tti© cord blood valu«8 relation lihip to infiUBt
iRortality*

Variable

ho .of
cases

CojDfi blood
arse

Cord aestm
creatinine
mm img^)

Cord sesMi
mric acid

Haan Cn^riS)

after birth

7

l.ti

; 3.TO

still birth

S

34.83

S.O'I

5.10

Alite birth

31

3S.42

1.57

3*80

ilbom dNMinratloiftii t^nxm tm statistical analysis
«^at cord blood uxsa is tsissd sigsifiosstlY is still bom
babies and in babiss slio s«|>irBd site* blrtb as cws^ared to
slise babies* Cosd eiestinls^ «sd cord siirics acid issalo mm
also raised sIflalfilMBitly I* stlU bom babies.

t •**■*♦*■• **^ #*•#****

*■* ** » # « •***'ft«*#*!»*f.* *

♦«**** »*•**«**,**,,

Itt ©#* • cNSiipiir^^ mw iBsyNaN-

i» M«MM ^lui «»»% CiM«ti»|]ii« md ii»t« mSM ««•«*
immt la aataaiai liiaai mM «©»i lilaiii la aaiml

mA tifivaM'lii flail lawia littva bata aaxial«t«€ wiMk

1^ ammtttf #f AImimi cad tla faatal inA aatcseiMi*

Hi eaiair ba find m% Ite aaiaal. iiiifii «ad mmmm
fain* at ^laod aiat la anoiMii twaS.iii^ aaa pmsffAm% fwuilMi*
Hload aaMt imm aManbad la ts iiibjaaia* flia blaad wiaa
ia tiiaaa Ml»jai%a amoad twm Hl»iB al allii a mmm

aalaa of 3 i*t 8 ao/tdO ml ^ s* 0 . 4 , 43 « to f lad oak liliolHok
•go lioo ai^ oiiook m blood vmm^ klio mmm mm AMAmA
lakO 10 yoarly mem fluii mtmm/l laiiiaii §m 090

10<^i yaaxo foagod bokifooa 10*10 oi^Oi ad utlii a wmm
oalao of li«ti ai^OO wA jt 1*00# boki i ooft it»0i fowoa
mmgm fwm I8«3S ac^OQ al ol^ o mmm mlm mi i0*0f mg/
too lai j; 0*0* 4»t$* is otoxa tft«4$ fooxa xwlood fxaoi tt*IO
■m/tOO at oitSi 0 aoai Yolao of Ii*fl z ao^tO w&m

Xk will bo 0040 fioa klMNa fl#a»wi Hat HaCTQbi^wo.a.;
dtfiogoaao bolwooa Haoo ftoosMi hmmrnm Amm mrn mmrnA ^
ifOBOOij Amm iot • waaaft t ae/loo at mM m ot otAot l Oii

51

»«• in ttm mm umlmm wwi innigni*

(p pmlm§ m&m thm e,9s hrnmm mjt turn mmpm) .

— ««„*»» to «*«t blood «« 1«.1..

®" 0* blood on. lo Boa»l trnim

HMyrUmU ato la oowshowioo, with tbo oiwomtloM «f

M»B <»*»). Cmtmmm (ud Tna^wt (ms), aaiot (l»SS>.
MOhot. nd ««dao (»«i) s,^ ^

******** ®* «*uoo naglBd txm »b 4 t mg/

too ai, aa^OO Bl. U.t«>a 6 . 3 S moAoe Bl. Jd-M B«/
100 al oad 10^ aoAOO al raopoetiwolr. ow boob waao od
a>.n ag/loo al oloMir ■MOiiiloo tba am wolao of ts.eo
a 0 ( np<ntad by Mom at al {l«« aad U .>1 ag/ loo al
Wpoftod by Madai at al (1004).

1> aonal bob pxagBuit faulaa waxa atadlad la
OKdBK to tlad oat Bowal laaqa and atonoa walat af Mxat
•••BtlBlBa ia aaaaal baaltlqr diaalaa* oaxta axoatlalaa la

iWteJSBlyf JliMJII ^ .EiiS Wit idililll W

OBlaB at 1.04 ao/loo al x «.*». fa tlad eat whaUioi
a«a baa aw MMat oa ama ecaatlalaB. tba aaaaa waaa
dltOdad lata 10 laady aoa gmmgm, ttm aana Biaallalai
la tha Odd t«aw »*-ti yaaia cawad fxta 0/t - l.t aWtOOal
mtrn a wmm wImi of 1.04 ae/loo al t e.M» batam to^
ftm it M»p| ituK M • i*i Ml Miiii M iMMMi miiiM

©« 1 * 0 « tm/tm m. ♦ s*i>. o.aii hm^mm s $-45 ?•««« it
xmgmA ixm 0 »$ • 1 aig/lOQ aO, mm mXm ©£ 0 *f i

•0/100 I»1 t 0*li, (Table KJO. 3 >

It ©ill iM wmm ttm rnmm ii 0 «ii»» If
••1 analfsla* ite tlw ihimi ini3mm wm iiwilf-

(f ip«liMs mmm la mxi ^pm^m W ©«•

^iMc«fox« Mf% fowii a© Mm mwmrnmim

12b ©»» BtMlft MIIMI Wlift WSl4 wm ©jMJtowMNI Itt
U mmm #f nuiswl iMaltlif mm mm^rn- 1» iim&

m% it» mwmX mmm «b^ anNiii^ ©BlaaNi* aBswi «ilff «bM
la tlMiM MtjMts wmm^ Mmm t«i * 4«t rng/im M «itli a
Miaa ©Bla© o£ S«2I^ iBB/lOO ndi 0«£i« 0«($S» TEa t ii tiii ©at
itetttts mm tBB Mf tf itcct m mmm mxim mii^ ^ib mmmm
iNiai ai©l4aA la to fmmxlf mm miimi txia antii

in Oiai# t0«as ]••«• fiiiM*0 tmi 2*0 * 4«i mg/W& at
©till • mmm m3m at )«2 migi/tm at x s«ll* t«iit| la mm
§mmp i0«^ fBBXa inag«4 ixm 2«« « 4*0 an/ll^ at ©tta m
mmm wmXm mi t* 2 t ag/tOO at ♦ 0*i2 8 * 0 * i la mm

faaXB xaaoaO ixm M • 4*t ao/tOO at wMH a wmtm
talaa «f itti rnig^m at x 0 «ff« (Table no.^;

53

It i« mm ttm m

tlm la wmm mMmmm nas ijiiii.f84fi«.

(tiunt Cp 'Vftlaas nMira titaa iMa 'SiscMtipa) « mis

tiMfafei* m»t iowiA t© af^Ket mmm mte m$M lavala*

Oat fladlaoa af aajran ai;ie mM mimmmm nitli '
tlia miliMMi of idUitoiO' «»i tamteai Cl9<tl| liio sopciftwl a
fwnga of l*t -* i.a wttii • mm mtm of j*02 Hi*

on* f i«i4liif a aiao isoMtItio that ottli ^ooo

m a»t«Nioa laif Caite Clf^l aaf King (ItSi),

jraa^^UiffinMor >

flM t>loo6 otto ttoiMii f iofoaae; la ti

ttaaoa of oat fmmmt mw$m m foiaif to mmm txm U
to IS rn^g/im ai aitt a aaaa mlm of tO«SS as/lOO aa
SftO. 4•i4• la osAoir to flaS oat fMatitf ami faota»

tioaal aiaa Iwia mm tifoet oa aatoxaai. lilocNt «Kaa# tta

OaOOO of KMiuft* IHOaO #•» mmuHiLmmm rnwmimmm ^

oa mi %m sttiMitlita fMCltf aaS aatajRaal tlooft
aiaa la tafafataS la aaaii la O f©*^** to* S > ip a t •

1% to aiiaoat f too tliaoa tatlao tliat la all ti

ijaasri aoaa twaa wmmm 'no a aptiaioww a aijapaiaapi' iiai na a i

imii^glllll iiai 'g|||g||||^||||[| aiiaifidl, m.mmm Otjcjini t B li ' jn# ai INi ii ' i i ii M ii it

III - fii ^ it#w •ilil tW jittimm

lEtBm^KJm^KBk 'iuBS

iii:;il*

54

^^*99 imlm m mumml htmrn mm mM

10*08 mg/im K| Siting mwml pxmmmmf wm fmnA t# hm

mirniM^Mmm tmmx mm mm mmtmm mini ©f »$.i8 m$/
too •! i« a** pwmrnmt

ip mhm Um mm Q.miU h mm»mM mi immrnm hmm hmm
»*t0 mmpmmthlm te mm mi la mm mlmm mi Mmm mmm
OiMtlaf acunai Oiucli^ pMMmmmy mm hUmA mlmm

immmmm maltiat ia • Ammwm mi litMioOiimtlixa* ht mm
mmm tiM liia oteaiaiax filtt«8laa lata iaeiNMia mmi
rnmxm la aa laeiaaMia asaa elmmmmm tiytOItt# lOill * faa-
tliaiwiaa# mmm la a mtaaslniila altaafiHi iwiOtiiOlaii aaft
OInlalaliad pxatala 8iaal8laiat wmmlMim im AmmmmmA iaa-
■attoa i»f HIM Cpaielaal, >

h mrnmM mt aapaata la timmmm m hhmmA mmm
laiaaia Oaalaf Bcmat pxmmmmf 0mm m^pact m mm 0baa»»
mtlaaa* caOdMi aad faaala (mm, mrnmmrnm muh
Caataxair aao TmmpmM (I0S9>« PmmmSMm mm imuAm (tpmh
mpm mt al (I90IU mlM CtfCI)# i^aMia aMl mmimliml
Cif71}« a l ali a aai Maixiaa (lotilf ojiia aad Saala Ctotil

mKwm Wwjp^WWm. m mmmm mmw&m mWmm WmJmm wm Iw iPpiNt

IttviO m0$ t0«7 •* Mit§$ mg/tm alfr ii«.t ii|i^i0 iHi 18 no/
too iOli ti MO/tOO alfseanp t7«4ii ai^oo wit t8»80 im^OOMt

Unfl *fii7 WllriiM Ml IPMiipwtt^ siyimyiqMI Vp vRMI

Vi^pyMI IHliPII mWMI UMi wPiraiM Wp Vf tm W^f§

mt at (it m0) aai tmmm aao lONiratiiMit iioal «Ni

55

« Mttl« mmm Wmm «n4 wmttU C1S*1» mm>9 MM

C^*® wslNl) j FttiwwSift I it | . ftim

Ci3*» md OJ^ ana Mim il%f

Qm iladliifs i»0Mi»3a ifitU ef

Kiflioia cbA twiisB* lf#i wnAii iil,)i iliaaMi •% id*

m« (If. 71 ne/icif •!) . tea l^idaA at «i, If84 (If
aonwi pmmmmtrn

Umtmmml mmm mimtlmim Mim mmml mmsm^ •

Sr l^aaamit Miiilaa «i t$ ^aaf aafixmJ. aaiwi
exaatliiliM xangai fxm M • t«f w^m wH if&mi a «•«»
iialwi of i.aHI aig/tOf id i;, t«44. x» mwMs ta flwi aat

^ aftaot «f paxifgr an® gmatatlMi an auitaxiiii3 Mix«i ««aa*

wMmUmm^ whW vavMi mSV swrwIW* aai t Wil i KMN Bt fHI wMI &mWMMm fiKK

lNUii.f3r wmI iioa af fauaiHifiaMi tsui wMwfainf Mil ft T^ir
la faftalataa la ®iifias«»% ia 9a3Rla m&m ® a 7*

It ia aviiiMit iaen ttaat tiftiiaa* oa atatiatiaal
aaaliaia« la «U af mOai^mmpx^ tNi p Mm m trnm
aaf twa aaa alaif* «f«» ttai f •ft. Mo alialf laaat

mjmrnwrn m» tlma faaiid hmmm mmmm mmm rnmMmrn
m3mm af tiitaiaat attgcail^ al paxlty m& iMWilaa af

liBi ilragjii-w .' .. .

56

of 1.26 am/lOO n3. it higtits: laioii tl** aoxiMi

otoatiiiiM ir«l»o of I *94 Mi im ofiM fMPtgoiflit fiMiiioo

C 9 YoilMI Imm tlwn e«@S)« CCraf^h No-z)

Hof xnoi ooiMo Milo ooi€ mioioi i^topioiioy 1

Hi pfooilt fXiMI of ii MOXMOi fffOMBt fiWi
Wm mtmt mx$M mi& xmmpni ttoo !•§ •* 4«t w&/tt^ Ml ipif
o Moon iroif of 9«S9 rno/im Ml x ®«s« 0«4#« to 'Immt oliirlMox
fo mxwk ocio oeif lofol fo ofioofi Ipf potitf ooi iMixioi

O PO ffOil* flMI tSMMM oOf foiflMix fiffboi iM mudLiMi'

ooilfxanipi Mfoxiiiii f **Ml potioa of foof %iiMi«

soxon mxlo ooM to OiCioxiMl; Iwi fosi fMoiofi

im tifeiio Ho* 4 4 t«

X% io OVifllt ifM foot t^ioo fO% OB. BftiBti*

Boi •BoifBio of oil Wm m3t%tm^0 ^ p mXm Mwimni «Mf
two 9 XOB|»o mm oinMf ^mm ^b mmw»Mmwm» m iiif»i«

fiOOBt fif iOXfOO WMI iOBBO ftlNMWI Of ff ^ f MM BXlM mi&

f XBOB of dif iOSMIt Bf OOXltf OOd soiclod OOBt«tlOB«

ff if lȤM tOSot of MMMXMOi MMOB^ BXf OOM Of

a«ai mmmPitm mmrniw ^ «xf obM iowi^B M

too 1141 of BOB pIBfBft iiBBlBB*(!OrQph No- 3> •

ititho* «a4 Tm^am CI9(6$> initiMi «pniti*»

nim $M mwml tsm 3.® • 4*e »i/3©0 m*

with « msM®! wiitti! of 3 *® ad# Foroudis© imd Agoslwi

Ci95f) ^lowa it hotMiwEi 1 *$ #. ii|/i®o «t* ott* fiMSlAf®
mmuAlm oioooif to tliot of coSian loif Wtami» tif li) Oho
•loo xofosMi mtm otloMi Mx hoth tho oaronpi# Viet»« msA
Follidc i»f»oftod aMMOi ooMi «tlo «cM «on«iartae*tiim i»
noiMol pKtmzamf of $,if m^m nl ♦ ®*^ which io

•llOhtlf liluliox tli«ii tho mmm mUm In mx pmmam ooirioo#

WMliool mK€ mm%t oiootlaioo m>A m$m miA iwilitoo
Ui mmmX MJkmtf mmm t

Hi oofioc to fio® oot tlio noiooi l«tolo of lilood
oooot coaotliiiMi aiti «flo ootlaotiiMi wm In li

of bloofi witliic«Mi fioo iflhiliool tolii «t tin®
of dolltocy l» aosMl pcopiaiit «••••• fho wstoilioal mwA
ocoo ill *5 o»ooi of oowRol mitmzf wmm^ 14 •• ti

ag/io® m, wim • iMiao ▼•!«• of i«#i» mA^ ^ X
Tlio notoMol blood «!•• lb tb*ao «•••• *oa®«d botwoaoi 14 •

S8 »S/1©0 «1 with » wimii tuloo of hS- X »*®*4#i4#

Xt io ovidiait fcoo iliovo obaoirtaddo^ thot tlMi wm lowtl

lii tbooo ttiriPMi of »©»iol xmmMM odboolf wildi

wm mrnmM owl 10 alvolf I««I^ ot^tiiitioal mMmrnmrn «nmi

itnwufi bttiiK mm two wolwwo tf imliii t*#iK

58

nm mtm mmmtimimm la mm hlm& ©f mmml
Amllrntj e«w»# ]tiiiQ«d tgmi ©.« • 2^2 rng/tm m with m
•mm wmlm of s,2« o®Aoo ml ♦ s,©* itutmiil. nonMi

exmtiMim im ^99 eo««i xmm&. iwm e,i *. 2.# msAm *1
with o aoiai intiiaMi of l^M rntg/im ni ♦ s*©* ©*44 i«o«
bio to mm eiootlMliio looolt*

tbo mxm iwtic l«voi« la co*^ blood of *S
emma of bo»mo1 dollvoiry coaoo ©f boimkI piMgaijit foiBaloo
•mgm& ixm a«i • 4«0 «l wi^ a ■«•«« toloo of 1*14

OfZ/3.00 Ml ^ 8#b* 0«4i« HBtoiml Mixoa mtlo <iK£ii lotol* in
tliooo CMMo sai^pd ixm 2*« •« 4*2 lag^eo ail with m wmmm
wmlnm of 3 •29 ng/lOO ml ^ s#o* ®#4f* loth walooii lOOOMblo
cloaolf m&. thoxo la no atatiirtsieilly aigaifiianih ftlffoiOBOO
oxiata botwawi tlia walmoa ip waXm m&m thaa 0#0i) .

Hjidlav oboorfatiiaia liavo booa .«ofio by aialio
and Noliaxjoo (It'll) who foiaxi aoao mtawamX aoi «oio blood
osoa tmlMO of 11*90 lagb and 14*1$ ogb* foopootiwolff ibaiMi
ot ml (1979) %die xmp&wtm mam aatotaol and eoid blood oaoo
of lt*fi at# and 19*99 aiiSl aoiqpoetiwolfi 0|bo aod 90X111
(19791 obo x^poxtad tba abooa tolim oa 17*7 laiA^O ail
and 17*9 wm/i^ ail xoapactivolf aad aaadioi at m (1MI4)
idio xapoxtod abofo oobaaa wa 19 os/lOO adi oad 19*94 am/ ^
im ml xoanoetiooly* fbaao aboMEvatiotta marnirnm mmm^
tiurti Umi mmm •■••fttoJaia and oxlo aold lo faiiMi bo olaiOi^ ,,
ofiol mmmamMatltB in ^ blood of oo^iax and ionMi*

59

*h. tat. «, eort Mooa «„

taxit,. ^ ,„ »p,..«t.a i. 5«,i. ite.

• «X1 ». It t. tartoitt fw. «* ^

ti*l« th.t Mtt eosl Uoo« „aw, to th, tob-Biwv.

*“«-»*"»» to p«tt, »« p.tto« Of 9.,totl« to

not algntotowitlr alM.roiit txom th. ■«» totoo o( l8.as
■a«oo »i (p „iu,. ^ o.os btoMto mr t« er«v.) .

*>» l»*ioa o( 9.,t.ttoii ma p«ligr «»r«fo» de net w»<m«
coid blood luu, eraottotoo «id «fi« m:i« Imoto.

a tol» WUfrt ^ tta bifelM bom ^ »»o».ort, tmmlmm ,

M*th %if«ii5rlit «>t tihft laf«]it« hi&m t© tin 2$
m^amX px«gaaiit fiiRAi«8 in ©me pmmmnt ©©ric© cangtd fxm
21109 • IBOO mB ni^ ft Kftftti iratiftft ®f 2790 ^ ^ S^O, 3 ®q^
tm 9w0mx t© ftsMftft til© e£f©et ©£ 9»st«tl©ii prntim^ h%mt
mimt m m^liical ©oto bl®ci« %mm, mrttfttiniMi «ei9 mxim
ftCiO# thft Bftw boaift iiftirft acia&»ii»f %© p«ri©9 ©f

Q©fttftti©a» 2h© Ofttftilft of tlkftftft xftftdiiiQft lift©© hmn xm»m^
•ftn^ftfl ia Tfblft lo* 19« It ift ©rlOmit imm tli© dNmi
9i>owrf’ftti«Bft tliftt MtftA blfth ©fti^bt© iMiifti ioiHfti to iiMiispiftoii
tbft Ijiiiioftftft in pftfioo 9©it«tlMi« Ho

ym hmmmg mtmtm um mi^h fotioO oi footiittei

m« Miiiciii tma vuoo, tmA «»l« mm lovols

60

^ich Mhmt «» iiisls»i.fie«at tlm mt MX Sm m ixxmmXt^x
m»mx ia tim irmxima putliit arnfaist

«t 9l ci»5«) ham that ^ hXxm af tlM

mkX.mxm mm hmm lafaats liiia rntmam 2SOO - 4i30. fn «ai
aiNixaQ# toatiHiaa S$oo •* S40II igpK^ &mx amms MX/igawm mM
17i0 PR lima Rfithlji eai»«i m»m feat iawis i^bwa mmm wmXwm
aSammtbaA by SaafoM «t ai Ctfii) .

^ar at mmm mw& fetiw® tmrnXm

of is* 28 ng/lOO Hi Ib aoisMl untipit b«gai«» bom to ooiaiiiS,
boaltby psopiiiit Mmlma tawmmXma tbooo of K12p«tri01t am
Maelwy (198S) oiio li«*o Obtasir^ « st««ei eot* bloofl o»ii« of

18*t og/lOO »l aof 8# HofEfao ot «I Cif84) #i® liiflwi Obosrowl
m mmm eosf blood mi»« lovoi of 19*84 lit nomotoialiNi

rntkJiimLMtmmL

IMNB •

toxmma or pnwmwct

flat aroi i iP. ., Mtf iFWniWf •

Out of 44 ««••« Of toKOMilA Of pwagmmxf* ti
ooooo C86*8K> boloi^pd to ago gxoog I8«2S yoaxo and If
•aoof C4I*Sf) boiongod to ago gioap botoooo if«4S yooto
(Tablo Ho* lid*

atcpidlttg foffl^r* mmSmm loobof of oaooo i*o»
so oaooo {4lalil> ooio ptMoM# iollOiNid bf 14 ooooii
C2i»iK| mmrn pam mA if mmm mm mm mmmM

pmsm fit ’iloofiotloiMi waipm^m mm fotltf otiii ^ 41^1 ’

61

iiicMwic* ®f toaciMmi* 01 picftgiiancy £«s0iiibl«8 to that of
ot ol. (ItSt) niio h«to aiflo xopostod highoot
incidaiico of tmmmis. ia oaaoo of 9xiMi.pmmm la a latgo
•otioo of aot® OftfMi* of toacaimia of fitogamcy# tlMioo
«at*io*« foiaii that 1270 (01,1154) aoMi pximAmxm, atoco
tho diaaaaa in eonaioeioatt im pjeliiiipata tha a^ 0»ot^ ala#
toads to bo looos ia ^is oomditioii# out flaSlags also
coiaeida wito tlioso mi Sath mA mmmlt Cliff) ia ifioao
aaxias ptla^axa eoastittttad #2*1% of casas and 39*a% ©f
easas nor© baloo 2t faaiea* ©|ha aad Satia (lili) la
Stiii^ mp^mm that 1 ^ ©t casas ^ffiRtiag i$xm tcocaomia
of Fxo 0 Baaef mm ptimiipmsm mo& 44% mtm amltl^^ata* h
tolatitaly hifhoK i»c.idaaea was ti^rtad luiiiPiojt sof aardlfig
tha iaeidaaoa of disaaaa la oxiial^ata hf EastaBaa aad HllJwiMtt
(1901) 77% a^ Shaxna at al Clit#) im sad FnhhiMftti Cl9$7)

tacoxdad lacidoaca 77,1#% la a^ 7i,95l la

oelisqpaia* Kasdaa at al (1984) mpmemA #S% oasas la Oft
gxoaps 1 #* 2 S yaaxs sad 3!04 halsamlag to 090 ixon^ of
yoaxs zosaBf»ias elosoly to oiix fjadiafis* Thay also lOOOXfNii
higtiast laoiilaaea # 0 % ia Fxlalyaxa ' f ©llowad by 2,9% la soeooA

pats and iSa in aoia than saoond paxa«

0dVMipn

Jil K >» »S^^S8WBKC' . .

fhn omNin of ton s wa i a imia ditldad Into HuMi

to mu oovogligr of mmm i M* out of #d oimmo

62

»tw«i«d in aa b«lofif«ai t© miX^ md

to hmXm<3«& to »mmm pm*

•etiv^psia tmd 13 mmm» hmt&mgtfd ia> oelAsqpwiii »ceo»IIa^
to tlio c»tt#jri« mmtlmmd ia laatoiriiil md ii«thoi»«

»loo4 oitoo Imi in oirotnll ^mp of tonoMiia of prof-
nancy ban a mwm vatoo of 3S«it *^i/100 ni ♦ s*D* i»03
»g?i. Thia iraloo ia than 20«0@ rng/im ml of i^tsaai

proonaacy and tha dU^xmem ia atatiatioatiy tiis^y aig*
nifiCMjt (p valoa lata tlian 0»00t>«

Otaa la«ala in €iffay«ftt daQtaaa of
haa baim atpicted in Tabl* «o, 13 & 14, and Graph Ma.4-

(Matanfial 6 coirll bloo4)

Tim Mataxnal blooa mi aa In 2t eaaaa of «iia mO.
mmdmmtm pxa^aclinpaia Jtangad firciii ie-33 ai^/lOO ad. a
■man oalo® of 24,7y ms^lO© ral * s*i>« 4,24. Ujtaa latala la
ooad blood in atom oaaaa iraa^pid f*«» 1©»33 aig/lOO i»l with
a Haul oalna of 24,10 mg/%PI» nl ^ s,s, 4,83,

Tha nxaa la^ala In natanial and ooxd blood in
eaaaa of noneal prafaumy in oita pxaauit aariaa waa a0,ei

■i/100 Ml and li«JI^ iig/lOO ml saapactiaaly, 1% ia mm
fxm tltaaa mmm that tiwaa mimp mm aaiaai In nm
and nodofata pxa«mcla^pala aa eenpacad to nonm^ l^napianmr*

Om »t«t4«ti«il tM» tin* in mm l«v«S.« i®

iMititmiil oa>xrd IblootS ln bi4m mtmxrnm f**F.*T* mwii

foittid t# hm hi^^y •l®aific«Eit If mXm 3Ui«i thiwa e*00t|*

Ott* rnammml UmA mmm Immlw et UmTf m^Am
mX %© tlMNMi xUsmvmA tey Hooftitt l»mm% m&

liMimx (i9S6K moA fiMaAdii Cl96ft| aiia iR«sdaii «t mX

Cl9i4) mmm yalua* mm t4*t wXt a4»« nfl/XO©

ifil an© 25*t mg/lOQ ni fniqsHMSti^iy* CiMpaxativniy lil^itonir
vaannn h&m hmm wi*t«d fey mmhxmxtn (Ifta) i*«* a» w§/

100 »ll mt %X Clf03) !••• iift/100 mil Jitonfmi •%

lUL Cit71} Mel® 1*9/100 mJU immx iralmnn

nf mmtmKml felon© mic«« hmm hmm xmAttm fey Cxmwfot© (lt4ll
l»o» 21 mg/loo mil Pie«fefe«wati U9S7} i««* 23 mg/l©© Ml f
Wxmsim C19^} i««* 32«2 mg/io© mlf sifeli* 9% ml Cl$73) i««*
1S»80 n0/lO0 ml «n© Sfeasewn o% nl (197#) i««« 22w#7 1^/100 ml*

©mx oox© feloQ© mim« 3 r*i««fel*» ©XmmXt feo %li«% «if
VmmSmm ot nl (I9i4> l*tt» 2#»4 mg/l^ ml knit 1« »li#©ily
liiUilioz tfewR tfeomt ofeootirmi fey siiiii* mA Mtoijmo (197$)

•a© mrnwm ot ml (197#) nfeoa* talmiHi mot# iS*20 mf/lO© wA.

«tt© 22«2S m©/ 100 ml loapootiirolf* .

*. 8WM rt—melmuiiM i (ito^Mwa mUt on* fc!U»a mmiH

3$i mx pmmm^ mt%9» of 10 tt«M# of ooooso pwt^

•eijnpoio# mo amtofiiol l^oo© nmm xmm*^ Amm 3i«44 »&

64

« wmhm #f ma mo/im ml ♦ s.d. 2 ^ 51 ^ c&x&

•« In mmmm x«agM imm 24<»i4 »8/t@© mX wttli

« Baas valu* of JS.j mg/loo ml * s.D. a,»».

ma itaa la aaaa Htanal aad ami u«ol axaa
X«ala abo«a Um aaaa rmUm, OfMnad la aaaaal aaatrala.

tha Xlaa «aa lonad «o ba htshljr aloalOcaat {9 aalaaa lass

Qrnmt) *

It Is mwUmt tmm tiui tmu We, It sa4 m mm
tlm of mcmm Imlm ia |M3sa.si!sj2P^0iii wr »il« ^

•oasrst# n&m&l is lii^ajr •!«-

fllfiCfflat ip mtmm isss tlhdUSt ©•601) »CGrapb No. 4)

Ottf »«t«siksi foi©©a vmliiss ©f 1©.*1 sm/lot ml

la iwmsi# pxmmXmrnXm cl<Mwlf fsasablss thorn ©f Kisliot
sad Tsadcai {10«S)# Smas st si (I9tl)i mmrnm mt si Cl9t«)
sad Issdsa st si <19®4) momm irslsss mwm 30*as «g/lO0 mlf
10*7® ag/loo ml» ll*63 mi|/iO0 mil sad 36*7 mg/lOO ml xss»
pssctivslf.

Oaat eoud blood mms elmhlf to tbosm

sbssrrsd by a»sz»s st si Clft6) l*s« 31,lt weg/im ml sad
»sad«i st si Clf04) i*s* 11*6 m/im mU

1* JiElgffPtIt, • CUs^MMMil m& ma& blood iimil

tl csmw soico sssil#»ls foe stiiiy Sa tbs pissoat
■oirlmst fba Mitoiasl blood mmm la ososs tsafsd

" ■ - , ‘ 4.; ,

J I , ' ' ' ’''v , -f J.'

65

ia-4S ma/loo aX with a Bean vaua of 3S.1T aa/lOO aX ♦
s.o. 1.93. Th. cota hxooa a„. ^

from 38-42 mo/Joo ml with . .

-w/ -a With a maai) waltto of 34.42 mg/loo al

t S.C. 4.82. n». th. ^ ..tonal ,»1 cort

biooa on f«»a 80 h. ^ ^

nonol mmtrel. .,8 ,o„.i pt,aa«ty .„a tho ri„ l,
tioally hlBhly olgBlfleant (p vaia,, i,,, th«, O.OOX) .

*•» matanol blood ana waa thoxofeni fend to
bo tory aaofuX in dlatooaio of aebniMl*. *ho rtoo 1b mabir.

BOX and eord «xoa and tbolr etmptilma la d^>l«tad In x^laa

Ho* 17 9WI& ItO^ one) Graph nJo .

Ottjf £iiiaiiig» io #cl«iip»ia mtm in confiMtion
witJi mmxlims cij««3rr®tiofi» of 3t«Bi<a«x «m5 Cod^ten Cl|l34)ii
I.o»c«t ftiid FliJiox {19S«5, Pmrnmtmtl UfSt), •% ml

C3ti73)i aii«iiMa at aX |lj|7§) idio li«vo xtq^ttod imi«ii auitooMdL
blood mroa figiixoa of n.m og/lOO wa, 3«*S mg/lm «!. 14*1
mq/ 100 ml* 414,4 ma/lQO ml# S3*471 mg^©® ml# 17*4 mg/1©®
ml# 49*0® mg/l06 ml xoajgoctlumly In oasog o® oolm^pglm*

Ottx amlma* ©f mtmmml Moo® «xo« I«t©l« <31*17 rnq/tm wa ^
©•»* 4*93) 111 foamMblo clooMf t# mlm 30*3

100 mi fopoxt©® by l*«ii©©t «md fSti## ii*i mg/lOO M

>1) tap»fii '(9561)

pue *(IS6|) ^3«Ni •mw^wjp aqq^ j® ®iti.

£numi>mmp pm* mm mnm^tw 3cwtmmmtB m tf«9 #%
i9pn5 » »® ftowi mmmxmp^ £wm w%%mi^mfomo9 »»im
toPEimaiM 3:0 w>f:i»wf %»3 •«|»i 4*1 .»®anii |MOi©f<| lari ••fi ®t
mmx •pmwmxmp itq ® 3 ® 3 ;»x»i|% tt?A mmm f® •aata®®!®
®ii»« 6 oid 30 «i m

»X®a Xx5^^ox'fp »x •«?*» «tf TOl^iiatawi wvif pm pootct mix§
a»3«®t3 »»3a *•%*» 3»i:ii*«ffl®x6 ®f ft®? ® »t

®i|3 '(69 fit) a»ii 9 i»jMi£i 0:1 Bmppxeom t»«« of

t«w*o«q» m mp •f iE»ii®tt9®x<I j© »fiiw»am5| 3 © »®sii poofq
taa»:^«» iif i«rfx *l^fq far®© pwi pdofq^ fi«Ei»%Wi at

•ftMMcec^ 3 ® iSaffHivxiiai airfx a pix«»i®fie^

8 f«j^ ©am mi% *mmm& ft 3 © ••fxa© xm wg

if©© a| Ift®©t:^st3aq-B :|8»9f3fafif« wp mmzm paafq

ar mpx •Hi '(fififii) fw« ©qfo pa* ( 94 fit)

auaaiis '(Cifit) »*fX8ipi|| pa* latafs 4q **

t^ao© f vuixaa pa* w$w4amimm&. 0 % pax*^!®* m wpm^bm%sm
tmm w| «Mipr«i* «x* •f*A*f mmm paafq poiap

Ip^iP^TPp’^PWPr ’’ww

W m 004^ i*'IC P»' aia^taiifaa «| fa e^i/eii ti*^ m

■miL^mLim ^ |||i 'ifi -imjiit -tfufflfc-n,. iituik. . j a il ii lil i i i t Jiiaiiiitiifc.: Jxttilyiii# %»

,ipMr|| lUiRR ifPp-P^ iWPiw |lHilil>|

•fMMMi 9m 9m m

67

KiiSi©* (1§$55, rnmmm et al (1971), smrn m% al

(1S73), Sh&mm at al (1976), Ojlia mA Sarin (1979) aM
Kaadwo at al (1984) lia'ta also jeaportafl inexaaainf laiwtl oi
»atafiMil blood asaa ultb l^raaadag iwfatity oi toaiaania*

(saaMi o£ toaowmaia of {>na|p«nsf 'moiw di’rilliHi
into tlkiraa groupa acooifling to tba aavaxlty of tcmania*

Chat of 44 caaaa atndiad in pxaaant aariaao Sairani o»tatlJii»a
loaal in oaasali gxoup of toseiMaia of ptognaney xiaigod fxoai
1*0 • 5*0 irI liith a aunui aalno of 1*88 »g/i00 atl ^ s.P* 0*7*
This wlua ia highar than 1*28 i^l/lOO ml of nonaal propMomsf'
and 1*04 mg/106 ml of non prafpiant groups. Croatitiina Isfoala
in differcoit dagraa of tomaamia has boon dopietod in Tab.10
So* 13 14, and GfQpl^^!o-6.

t(llatomal and cH^rd blood)

tho matamal sansB oraatJUtina in 22 eaaoa of
mild md i^dorato pmoolampaia raagad frem 1*0 - 2*4 ag/
106 ml oith a msmn talno of 1*5S mg/lOO ml ♦, s»i>* 0*14*
Cioatiiiino loirolo in cord blood in aama caaaa rmsgad ffom

§*f • 2*0 mg/iOO ml nlth a mowi talma of 1*47 mg/ld® »3l X
s*»* 0*34* It ia anon ffom ab«mo flgmraa idiat m^lmm
atm xninad. in mild and nodojMi «• i»ii#a*«id

noismai pmgmsmf* om ata tiattol imalfnin* ^ find ^
tinitan inmaln In natnwnl 4 ®d mvS, Mood^^ i» 'mild mad mod»«iti

68

I (MateiTMl ud opid blood )

^ pooooot oorioo of 10 eoaoo of oovoso
pnoelo^oolo, tbo ■.tom.l „*«, orootiafn, nagod fton
>.1 - 1.J oa/ioo «1 ,rtth . .* 1.„ ^00 ^

1 3.0. 0,43. COM blood cioottaUio la aooon p.e.T. loagod

fraa 1- I.S ag/ioo «! vltb . mob nlno of t.» oa/loo al

S#D* 0*4|k

3li« rim It nmxm tsm&timim in
cojpd blood abm tbo nomni control* l* deleted to Trt»lc
Mo* li and 21 md tb* rim wa» foniid to bo highly olgnifl-
c®nt ip T«lu*s Ins* than 0*ooiK

• (Matamai aud cord Eoctajsi cmatteino)

In 12 case* aynilid>3Ji for study in prosont sorliMi
tbo footoxiMiX soniBB orootinijio rongod from 1*2 •• S mg/lOO wH .
ultb o aeon valno of 2*S2 ag/loo al ;<► s*i>« 0*g<i* fho cjcootl**
nliai lovol in cord blood in those cases -xongi^ froa 1*2 *• S
ag/ ISO al with a SMian iraliio eg 2*SS ag/lO0 ml ^ s.D* d,il*
IHitts tbs aoan irslnes of aatamal and cord oroatlnlno am
fCKUSMl to ba irairy nneh raised as cca^rad to noxaal cmtrola
and nosaal pragnaney and tha riaa is statistlaallf bl#ilf
aifalficaat Cp aalataa lass than d»09l^ • fba tisa in mataimal
and caM araat^iaa la aalanpiia and tbalr cmpaiEiami $m
dapidtad In lyilaa So* Id wmd tl, QncL Grctpb No - 5 .

69

lu €Mx mmicimm of 44 c&mm^ th« cjcefttiolrie
3.crv«l« ohoiiMHA ft xim with iacirftftftiag sNtwftiritjf of toicft«Kiii
in tftfttftinftl mm hlooi, nm ti«ft i» aiostt li^if icant
in cftftoft of mlmepnim and mmmm pm than wild and iaod«sftt«
PL^m Thi* riftft ftdfht btt dno to ahnoimlity in »«iiftl fmc-
tionft which occnjfft in tosmiftiRift ©f pmgmAmcft

lJi.,..toxftftiaift o f....ii3roenft»p y t

Thft cftftttft ©f toxftaoift of piTftonftncy wone divided
into thrftft group* acoording to sovarity of toxaiawla*
of 44 cftiaft in pr«g«it serifts mxm uric acid l«v«l in ovor
•il group of toxaMia of ps<Hpi«iaey ranged frexa 2,8 « 8,0 lag/
100 lai with a naan value of 3,9i lag/lOO ral + s,D, 0,®8» fliia
value ia higher than 3,29 b^/Ioo ml of nomal pregnancy and
the rise ia highly aignificant (p Vftlua laaa than @,001| *
Oric acid lavalft in diffarant dagraaa of toxaaaia* haa lawMi
depicted in Tabla Mo, IS and 14,aoci Graph no • 4 .

MiM to. llodo.iftto i (Matamal and cord blood)

flMi iMitftmal aomei uric a«tld in 23 eae«a of aild
•ad Biodorato pto-oclampaia ringed from 2*8 • S lag/iOO muI
with a mion volwo of S*4t *1 ♦, s*o# ©*ti* •arm*

•Sid Idvois ia ooid Mood ia asm mmm tmm& i*«a -
4*2 iiiA^ aJ- tMa* ai *8/^®® ai J;

WMi Wmm Wm m

wmBml la mm pmmrn aaisiaa mm rn^m

70

l#34 mg/lCQ lal risirp«ctlv«(ly. On »tati®tic«l
thi.» ris* in «Hit#«niii and c^trd «*lc aeid in mild

««<3 Hindni'at* l»icn<»clii^«i* wa# a®i si$nific«nt (p yalna
t»x« than 0*05)*

i (Mat«x»«i tti»3 mt& telond)

la pr«»«at tmximm n£ 3.0 caaaa nf MNnisa pwi**
twiiwipsia tlMi iiatninauii »mwm »»ic miA tmegmA £»(ai« t*® •

5*2 flWi/lOO ml ulth a nttaa vain® Qi 4*14 mg/iOO roi ^ S,D»

0,86* Cord mxam aric acid ranged from 3t2 - 5*2 mg/lOO ml
with a m&m value of 3*03 mg/lOO ml ♦ s*o. 0.74, Thia valam
if higher than th« imm value of 3*2S se^j/lOO ml in iMmal
pregnancy* the rise being highly aigaif leant (p value » l«»i
than 0*001) ,

MsMmMM >

internal ai^ cord blood of 1 2 caaea were a^il««»
able for study in present series* the maternal serum nrie
acid levels in eclampsia ranged from 3*i «* 6 mg/iOO mi with
a mean value of 4*7 mg/lOO ml e s*B« 0*83* The seinim uri®
acid in eord blood of eclmupsia cases ranged from 3*® *• ®»® '
mg/100 ml wil^j a ms'in value of 4*6$ mg/lOO nl ®*l>*
fhne the mean value of maternal and cord bleed ttrisr amid " " '
ate raieed m oeeguired to noxsml 4mtsols and imiimal preflweil^
lihd til® ria® I® hi0ily signlLfl®«Rt Cp values leas th«i

71

Thm chaivg «9 i» uric acid coacMitxatloii in diff«i«ot
d«gi»«s of tOKBOmio i» mat«iii 9 l i«id cosd l>l«w>d lia» boots
trtsulatod iin Tifclo iNi« 19 assd 22« and Grciph no-s -

SoiMijtoi ooxlioxa li«i?o xogrtsrtod « ooriot of iraliMMi
of iticlc acid concoatiratloo ia oatarml blood to aosoal puso®**
aaiscy and tcmamida of propsiiiey* «ad fisliair C19SS)

ahoii^ m®m axic ^id looola in wild loid oodoeato pxooolani^oAo*
»tvoxa psaoclai^aia and oolip^aia aa 5 wg/ 100 ml# 6*24 m$/
100 ml and 7.46 lag/lOO ml jraspectlvoly. Thmy c^iclodad thab
lavela of axic acid em mrm aa good lifcoratoxf isidicato*
in of psregisancy* Victor lisd l^ollidc C19®9) roporteiKS

bigber ’^^alaaa of axie aeid i*«» 6«4| mg/lOO ml in toxaamia
of pxa^nancy* Standax and Caddan Cl934> alao concladod that
dagxoo of bspox axicanla cN»xxolataa 'aoll tritli aeaoxity mS
diaeaao. fbay x^poxtad a moan valaw of 4*6 mg/lOO »1 in pxo*
•cloRipaia and 6*2 mg/100 ml in aclampaia* Kiabox and Tioidon
(1965) xoportod naan valaa of 5*2 mg/lOO ml in mild pxooolimp*
sia* 5*63 mg/100 ml in aoaaxo pxa^aelampaia and 7*2 mg/lOII ml
in aclampaia* Gupta at al (1963) xapoxtad maius oalua of aaxiit
uric acid aa 5.5 mg/l©© aO. in mild i?.E.T.# 6*2 mg/ 100 ml, im
aavaxa pxa^aclampaia and 6*7 mg/lOO ml In aclii^9aia*Pri^lMmNiliit
(1957) r apoxt a d aaan valtMi of aaxnm nxim meld m 4«4 mg/ltt
ml and 5*5 aij^OO ml in aild* mmmm pxa«<aelaM#«lm «»€ melaiiip**
aia i^mpaotitmlf «

72

J*5f1P«jna*lca,«rai® |.ii toK««mi«a of prc^naiwy can
hm an* t® «ccwwa«tioa of mtic mi& In telooa m» t®

f*nal «3ic*«tioii, iHlmimisliad «a«»t3recti€m hj llmx and
•aecosai'^* i&mmtim aaaociatad idlth iim«tm3kikX »»*irti®o dujrijif
©<mwl®ioB** Ml h«m hmm ii«gg®»t«ai a«

IMtfflltl and infay^ atogtmii^y t

la mix p 3 r#®« 9 t safiot ®f 44 OftHiMi of '%® 9 Citamia #i
pr^aaacf d®atli occuxad in 2 emm of to*a««ic »»ot)i®jeit(4*9jsS)
and in Is nan feein infanta (29#!^)* Tim toatiwwic nit®

•acpljaad wmm c%mm of iwsiiapaia and had mean nwtamal mnaai
of 41 nig%», a^an sexim craattoina of 3*2S m0i and aman aoiufii
nrlc acid of 5 mg/loo ml* Mataxnal daath rata in «cla®i|^*ta
was 16*^* High natarnal blood oxaaj^ aoxnni ctaatiain® aidl
mxtm nric acid nor® »or« and ati^t tso jwi^xanol&lo foa: dooili
of BlOtliajE.C Table NJo.2.3j)

fho peicantago of Inf ant oortalitf in niM p»m*
oclawpaia wa# 4,m# in aororo pna-oclanpoia mm SOSI ond In
•cIaai»oia mm 7S%* In Si naw h&m infan©* oho JoianidMMi nllooi
tho nowa «oxd blood oroa waa as«4a mm/t&& nl and 7 mtm tmmm

«dio onplxod otbhln 24 hour* «ft«r his^ mmm mwi
wm 34«iS niAdO «I and In # atlll bon»«« it mm 34«tf.u« Wiil
coxd blood ntao looola tborofoxa Indlcato' 'dWifaf to th* HAii
Of fMMr biOHi Infaiita and oooM bo bols^lhil In ' Jiiftttliio tli o

nf nm iMon Infaiit In ©o noiPodyMOf* n '

'>#.Er*i4S3«a^KS SK:i

• ■ ES?S:|«k ¥,s^ k ■iklliiS

73

«i^iiifica®t c»ri»la%ioB. tli«r«£©s» aisiBtadi, twntwaaii
blood mmm UvmU and mortality of infant atoilar mmcm*
latlon OKiatod cori blood osaNatinijMi and mnbB

ncid iftiicb Mai 3*0*1 mg/tQO ml and 5*1 ai^j/l@0 ml mwfpmc-
tlvily in itill beim.CToWc No. 2 . 4 :)

Randan at al (1984) xaportad natamal aottalitf
rate of 5%. Prabhavati at al (1957) taijojrtad 6*87%. m
agZf'e with Manon (1969) end Ratdan (1984) that maternal ■
4teath« in toxawia was doa mainly to aelaoiqpaia as none

of tlwi matajrnal death occored in pro-oclanp'Sia ca»oi of
cmx saxies*

«

It is ovidant ism the fabla lio*i5 that blUrtli
iMlght of tha izifafiti boss to tmmmlc leothoxs falls ifitb
Ijwxaaso in msA oxaa* oxaatiniiMi and uidUe acid Isrvoliib
Out findings of invaxssi xalati^jdiip of biirth ooight end
e^xd blood ttzoa lovols axo in oonfixsuition idlth thoso of

Sjostodt (1996) I Kilpatxiek and Kaokaf (li'ltt)t ^Lidia and
rnOmtSmm (1973)1 mrnwrn «t al (1976) 1 Ojlm idd iaxln (iffil
and fttadim (1964) sho haso hi^ mm bliwd dXMl

loo toiith 1* ^icaaBiin of i^itiHliiiiiif.CQTQpbN^^

74

Omr licve r«v«aX«d that;

th« matatnal and c^jcd blood nsaa^ ©^oatiuiiia and itcits
acid ciaacaBtrat^ma irlaoa «lth lioemaftiiifi iwnwijfi.'tf’ vt
toacoamia* Tha asean bifth walght «raa fooad to dLmmmm
and tha neaii coud tavaaD cisaatinljia aod udo fuamd
to iMexmm»m with Ihetoaaifig aataxlty of bOHaanlo of
pxe^aiancy. PmUkmmm ilW} hairo alao obMunrod thids tlia
dio|jai.atittd foatal wai^bt waa aox® with iacraaaitif aawxitgf
of tOKaamia# Oux obaarvmtimii elao roirambla with tifia find-
ingm of Sjoated at «1 C39S@| who aftar aatlmatiog awti
pxotain liltrogao coocantxatioa in oaijilical co»l blood ©£

©04 tefafita, ahowad that tha coucaatxaticai xoto with in*
cxaaalog sigoa of dyaaiatuirity aod haw poatolatod that
raliod plaMm nem protaia altxo<jaa eoiicantratioii In dya-
laatmrity was caaaad by placaetal inaaf f icioticy whldi

prof^atad tha foataa fxow awratlag n«m pirota'Ja aiteogah
fro« placenta# On atatiatical enalyais a aignifidaht dlft#»
xance was obsarvad batwean birth waight in mild and aodarahi
pxa««aclampaia and aavare PHD (p valua laaa than 0#01| and
highly slgaificaiit diffaxcnca was cd»aaraad botwaan adld m&

Mdaxata PHD and aelan^aia (p waliia lass t^iaii 0«O9l)« XdiMI
aignifieant diffoxancm waa cbaaxwd batwaait awwia Pit aMl
•elM^paia Cp yaloa loan than flia walitaa ax»

in % 0 i 9 Gr£»ph No - 10 and-

I I

76

m C l„Q„M B

Olilt pxmmt hm %«tm& M&iymrisi/Q

emclmimw: i-

1* til* HI** la aaanul l*®alttiy

imitti zaagaft £i«mk 18»33 »ftAS© ai i#t«h « immhii
irala* of l%^m mg/lOO ml ♦ a.o* 4*43.

2» ttwiro i* atatiatieidlf si^slfJLcasit ©iffownoi la
a»«a tolcHSfi ax«a ceiieaMtsatioa Ja ^ffarwat »ge gxmp»m

$m Tfm mmm cxaatlol*W! in haalthy famalwi

iraxias from 0*i - 1*5 mg/iQQ ml with a mmm v&lum iKf
1#04 m^^lOO ml ^ ©•2241

4* lyga haa no af facet mat mxm eraatlaina valaaa la mm
pragnant famalaa.

i« saxom nrla aei4 in aesa-pra^umt famalaa rsiHifO© fxiM
2*6 - 4*2 mg/1^0 with a mman walita of 3*SMi mi/id©
ml 3» SsD# 0*Sl<i

§• Tliaro wa« no affaet of on mtmx mrio aci€ walaaa
in aom piagnaat faimilaa«

t« tho blood itr«i la normal progstaaef rangad from I4<*li
iiii/100 ml witli a moan wmliMi of 20«0ft mg/lO© ml x» ■
4«4i* ttiia walaa ia I*i« nom pxafpant $mm ^ssM
tim 4$Mimxmm la blghlf aip^iJIaant*

77

i* mxA ugmm Imml Ms mlmott musml to foiood aron Ijt

nomsl It tmgs& from 14 - a« rag/lO© ml

■wim m nmm vmlm o* 18*28 ioq/IOO mH ♦ s.33. i*©4.

9* 3«r«m evoiitietiMi in noiwii piregii«iMBy rmigtd

ifrnsQmm fxm 0*i -» 2 na/lOO »1 iritli « laoitt imlwi of
1*26 mfi/lOO mi ♦ s*D* ®*44* ftii* valKWi i« Mffcwii'
tli*» oon pxmgsmt ^x&ap b«t tlio (ijtffopittco it »ot
mwli ni^pificttit*

if* Serm orlc acii i«if«l in noim®l progiaaiacy raogo® £*f 0 »

2*8 - 4,2 mg/lOO mi a mean vaioo of 3*29 mg/lOO mi

s,D, ®,46, Tlila vmlm ia almost oqtiai to ocai pm^mt
fsoop aisS tliwro is oo signifioi^t ®iffsrsi»e« hmtmsm
til® vaiiMss*

11. Is oo^sisl p»tg»ai>ey p®tio4 of paststiim sod pmAtf Mum
no off act os mess mxm iotois, mosm etostisiiio iooois
«a8.!ii® 8S sric scM i«t«Is,

12, Mom 0 OX& cxmmtimixm lormls is nomsl piro^siisoy

from 0*8 •* 2,2 mg/iOO mi witb a moss vsiiio of i,2i wug/

100 mi ^ s»i>« 0*4 sliicli is siiaiisx to mstofssi osostiiiilwi
ieirois is Boxmsi pjcoosssey* ^

13* oyi ® s ® !ii i i t is 00 x 8 bioofi of sotsssi 8 oi ito, iios xmsymi

fson 2*f * 4 mff/lOO mi witli a amtss irsiom €M 3*34 wo/IIHI tsi
i; s,i>« 0*41* vtils wmtm is sot siQsifiesmtiY
flOMK MNSi IMiftlHr fW i y SSIMK \ ^ ''7'

14« fluritf .ii^ m mtaM$km witti

cord blood value# Iti uorfnal ftfugiiancy,

15« Birth ««ight« of th« babioif bora to aowal pmgi^mt
laothar# rungod fraa tom • 3S00 gw# with a meaii valaa
of Tf&i pi ♦ ®*D* lio* Tim iteaa birth taiight waa foumi
to iaereas# with tho ii^roas* in parioi of piatation*

16* Cord blood valttoi dew# twot vary %dtli birth waight io
fioaaal pxiigr«»ey«

17* Tcocaamia of pragoancy i« laora coitimoii in primip®ra 4 f
in 16 • 25 year# ago group*

IS* Moaxt blood uroa in mild and nodorato pro-oclan^aia
roagod frcM IS - IS atg/lso rtH with a noon valuo of
24*77 mg/1 00 ml ♦ s.D# 4*24, in aovoxo prooclMpaia,
from 26-14 mg/too »! with a moan valiao of 30*1 Big/

100 ml t s*D* 2,52, ha oclawpaia it rai^od from 3»-42
mg/lOQ ml with a moan valoo of 35*17 mq/lOO ml ± S*b,

79

20* rnmm sMiriM tmtlalii* in nlM md

xmgmd from 1 - 3.4 «ag/10Q ml wltb ® mmmn rmlm of
1.5S mg/iOO ml + s.D. 0.34. in mmxm P.e.T. it
r«ng«d from 1*2 - 2*5 mg/lOO «1 with a metm iraliio
of l.SS PC/ 100 Bd s#D* 0*43. in oclaBipfia it
raUQpa from 1*2 •» S mg/I 00 »I with a wtan iralii® of
2.52 rag/lOO ml S.D. 0*|ifi. Th« riiMi mmx nopnal ■
progmmMTf la hichly aignif leant in mmmm proaolpapnin
and eclM^la and not imiKsh significant iUi mild and
mDdoxato praocliiapaia.

21. Maan aanaa uric acid in mild m& mo&ax&tm pmmclmuprnim
ranged from 2*i - 5 i^/lOO ml %fith a mean value of
3*47 aig/tOO ml ♦ S.D. 0.71# in aewro praMt®l«apti«i
4.14 Rig/loO ml * .S.D. 0.86, in iMslawpala 4.7 mg/lOO
ml ♦ S.D. 0*83. The ri** in mild to modarato gxovip in
not ait^eiif leant but is highly significant in eason of
sovoro pre«>«clai!^8ia and eclampsia*

22. Tha uroa Itvol in cord blood of mild and modarata pro**'
eclampsia ranged from 16 - 33 mg/lOQ ml with a arntim
value of 24.16 mg/tOO ml v S.D. 4*53 in sevara pro**
eeiampaia it ranged from M^34 mg/I 00 ml with a aieap'
walpe of 2i*2 mg/lOO ml 2«@0# in oelpapBia it

rsfnged ftem 2®«»42 mg/loo ml with a mean w^lm of 34«4t
»g/IO@ «l t 8«D* 4*62« f3i« fsord blood mea imxmmui

80

irtth (milty of tonmla aod tho zlm

pregnant level is highly significant.

23. Thm creatinine levels in hXoo& &t mtl& and

mcderate ' pra-Hiclaj^sia ranged from 0*9 • 2 «g/100
ml with « sieai! valne of 1,4? «g/100 ml t 3*D* 0,34*
in severe pre-Htclssapsia it ranged from 1 - 2*5 mg/
loo ml with a mean value of l,?f mg/100 ml t s.O. 0,4
Mad in eclampsia it ranged from 1.2 **>5 mg/loo ml wil^

a mean value of 2,55 lag/lOO ml > s.D, 0.®1. The increea*
over normal pregnancy is highly significant in cases of
severe p.e.t. and ecla^sia ai^.not very aignificMBt In
mild and moderate pre-eclampsia,

24, uric acid levals in cord blood of mild and moderate
pre-eclai^sia has mean value of 3,3? mg/lOO ml v, S.O,
0.49* in severe pre-eclas^sia 3,93 mg/100 ml t s,D,

0,74 and in eclampsia 4,63 mg/lOO ml # s,D, 0.??,This
rise in Cford blood uric acid in eclai^sia is highly
significant and less significant in severe P.E.T. but
not sipiificant in mild and moderate P.E.T. -

tS. The tta^aiil mortality rate in toxaemia of pr ewsiantf
was 4*» and lafaat mortality rate was 29, »6 iwsimimg
t%mM of still birth rate and the maminwn number of
death Oecored la eclssq^sla#

81

26* Higli liwwil* ©f 4t nf/too

€.f»«tlJiitt© lmml$ ©f 3*25 »g/io® ml «nd mtlc mM
Im'wmlm &M % mg/lQQ «l, fet«i:*aui» ggtmvm pt0ffmsiM $M
tmmit ©£ iaatwtwsi laojftility*

2?. Iliii>il4©iil cowl «f©« ImmU of 34*26 ng/lOO ml* cmtjU
iii»« l«fv«3,« of 3*©t iif/lO© ttJL mM mim arid lirvol* of
5*t r^/ioo m3 of moxtt Mt% iiidil4?iitiiNi of irrovo pioQno**
itio £of io£«iito la tofmo of mortality*

28* T!i« teirth woiglA of »«w boro i«f«»ta 4» ttmaamia of

p*O0»i«Sf tiofa to ba with lacraaaef iMBNroritjf

of toyeaomia tho larfbllical eorf mroa lomal liarmoMNlhi
Avora^o birth woi^ht la milf m& moforato f*e.T* woo
ttiO gm ^ s*©* 22®, la mmmm P*r*T* 23iQ ^ s*D* 326
^ i» mlmm^ t«t® m ♦ tis

26 * Tim matotiiol bioo® ao® tho eorfl bioo® mroa* etoatiiifni
aa® mrle teif aro not rolatoi to fNariod of ®oota%icMi
in iiomii aa woil ao t«Ki»iie

82

^ ^ ^ ^>....<31 g...li ir

i, Braai, Grtes, J*K. «is« Littl®, V*a. t

J. Pudlffitr,# 100 t 1S5, 1982*

t* Bucht*, H. Scarit, J* i Clin* Lab* Inv®»t, aipple.S* If SI,
I* .Biicht*, H, and vi®3t5co# L* * J, Obstet, .?iid Gynaecol* Brit*
Itep., 60 I 1S7, lfS3,

4, F, and Parilt* E.J* i A, J* Ob»t. Cyisa**,

32 • 421, Itas,

S* Ceddon, J,F* jind stander, H*J* t te-., J, Oteatet, and
Gyntocol,, 37 I 3'7, If 39*

Cald%Mli, il«E* and Lfia, vi,G* t J* Obatet, and
Gynaacol,, 2 i 17, If 21,

7, Cantniroif, A, and Txnmixar, H, i Clinical Biocbmistirf,

5th sd,, if 55, smmiimm Company Philadalphia and London,

8, Chaalay, L*c, t Am, J, Obatat, and Gynaecol,, 95 i i27,
1966,

f* Cheaiay, L*c,, lllaabath, E. ®t al i J, Obstet, and
Gynaacol*# 42 s 976, 1941,

10, Oaafo*i«# D, and Hull, E*w, i Am* J, Ofestat «fid Gynaacfd.^

7S • i34, lfl», ^ ^ '

11, ooielmatt, Wed* i iSmmmAtt &i pxafntfMtf, M M,

Limidii, p »«# ISO# lt»t*

I mm *2'm Oh»t&t.

iAdm, London,

Diwlopt w, and J«M* t Brt* il* ©f Obstet

HVJ« B«d mii8«ii# WM, Milliaaus I Cl5»t#trie

If 67 * ViwwfGtk iip|>l«iat«i ceBtmrf 6 ©£t« Inc

Folin, 0, I J.A.M.A*, 6f • XaOf* If 17

Firaitcis i <S» Ob«t«t* and Gynancol

India, 9 • IIS*!

iCoth«£i* L«K,* m& ^npta.* 3*11 • i J* Obstat

Inaia* n I im^ 1963

Hntcbieon, b*!*

Kally* w*Y.

Wxlm&mm, s»A« imd Pit

K*R* and C^liala* 6*K* i J* Obstct* and Gynascol,

ijTlc^t and neXiiY, i» i #ba«ii«* and

c« mil** fa • m% i96»*

Biochen.

Flgher# X.L. t J* Ob»t«t« end Gynaecol
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M,, Keniede* Horta, 'J,L, and liuittlch, r,i

He Kay, E* and KJLlpatxlelt, s,J, i j, Obst., end Gynaec
l*lt, C.wltb,, 71 t 44t, 1964,

Meiw®, K, I Obatetrlcs m i» liaiia. MoieiM T^eeasda
In obatettice eH&bet by Kellejr, Piitoliabeje,

biitteK Moxtb, hmdm-.

ll« wmS$mm9$ 9*§ vfmewiMmt amS O# lUUiiKman t Obatet
mA U • 6i7, 19S7*

m

34« Wmxcg'vmU K* • Kanual of Obatotric*, Ed. 13tb, jr,& A.
Cterchil Ltd., Loridon, p, 83# 221# 1969,

3S» I'eturs and Von Slyka t Uraa cl«?aj:«nce test,

L'uantitative clinical ChTOistry Cp# 966# 975),.

1#« Pollack# V.E. & tJobn, B, Nettlea, t Obstet*

end Gynaecol.# 79 i 866# I960.

if# Prabhawati# R, t J. Obst, Gynaec.# India 8 •58#1957.

$8# Purandare* B.p, and A^jashe# S,V, i a, Obstet* ,*nd Cynaec.
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Riedel# J,A* s J, Obstet., end Gynaec., Brit, C,v?lth,#

70 I 456# 1963.

48# Rohtagi# p, and Tiwari# K. et al i J, Obstat. and Gynaac*
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41* l^sel# R.A.# Gloria# E.B## Goarga, T. i Am . J. Ob«t.
and Gyneec*# 7® t 375# 19S9#

42 # Sanford, 13. and Clifford# G*# Grules « Cfiaptet# 42# p#15#
Publiaber® w.c. Prior Cosapany# i.p.c*, tf.s.A, 1956.

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44 # ^aaiaiia# S.!C.# Umvtd .0 s#^ Ktiartt# 8. and FaMe# d.$ 3. t
J. Obatctt. and O^aecol# India# 32 t 766# 1962*

4S#i P.F## CamwaiJl# w# and Boyia# <7* A# t CiinicaJl

■odloiiiat 47i $it« 1974#

md Gy»a®ci9* 146 i 107, If

—

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