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Category: Volume 08 Issue 02 February 2020
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Title: Effect of maternal hyperuricemia on post-spinal hypotension in preeclamptic parturients undergoing elective cesarean delivery: a prospective observational study

Authors: Sheikh Irshad Ahmad, Syed Yusra Imtiyaz, Shaista Yaqoob, Tantry Tariq Gani

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.42

Abstract

Serum Uric acid (UA) is a marker of oxidative stress in preeclampsia. Hyperuricemia has been shown to be associated with impaired vascular relaxation in some retrospective studies. Elevated uric acid is also an independent predictor of hypertension. This study is designed to study the association between elevated serum uric acid levels and post spinal hypotension in pregnancy induced hypertension patients undergoing elective caesarean delivery under spinal anesthesia, as measured by requirement of vasopressors.

Materials and Methods: 204 patients with pregnancy induced hypertension scheduled for elective caesarean section under spinal anesthesia were included in the study. Demographic data, anesthetic management and peripartum course were recorded. Serum uric levels were measured on arrival to operation theatre. Doses of vasopressor agents required after spinal anesthesia was recorded. The association between serum uric acid level and requirement of vasopressor was studied. Data was analysed using students t test and chi-square test. P-value<0.05 was considered significant.

Results and Observations: Requirement of vasopressors was lower in patients with high serum uric acid levels than those with lower serum uric acid levels. Results were similar with both phenylephrine and ephedrine. The difference in vasopressor requirement was statistically significant.(p-value<0.05)

Conclusion: Elevated serum uric acid levels are inversely related to development of post spinal hypotension and requirement of vasopressors in preeclamptic patients undergoing cesarean section under spinal anesthesia.

Keywords: Serum uric acid, Post spinal hypotension, Preeclampsia, Vasopressors.

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Corresponding Author

Tantry Tariq Gani

Department of Anaesthesiology and Critical Care, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India