Details
Category: Volume 08 Issue 07 July 2020
Hits: 939

Title: Homocysteine in Hypertensive Disorders: Time to Focus on the Neglected Risk Factor

Authors: Dr Shaina Chamotra, Dr Ankit Chaudhary

 DOI: https://dx.doi.org/10.18535/jmscr/v8i7.73

Abstract

Hypertensive disorders of pregnancy are multisystem disorders consisting of  pre-eclampsia and eclampsia and are a major cause of adverse perinatal outcomes.1,2 Both mother and child are affected equally with serious implications. In addition to elevated blood pressure, proteinuria, and convulsions these disorders are further characterized by ominous impaired liver function, increased serum uric acid, decreased platelet count and signs and symptoms such as headache, visual disturbance, epigastric pain and pulmonary odema.3 Though endothelial dysfunction and vasospasm have been considered central in pathophysiology of pre-eclampsia, our understanding of its causal factors and etiology is still minimal.4 Stipulated theories include abnormal trophoblastic invasion of uterine vessels, discordance of immunologic tolerance between placental and fetal tissues, genetic and dietary factors.5

References

  1. Mujawar SA, Patil VW, Daver RG. Study of serum homocysteine, folic acid and vitamin B12 in patients with preeclampsia. Ind J Clin Biochem. 2011;26(3):257-60.
  2. Dutta DC. Textbook of Obstetrics. 9th Jaypee Brothers Medical Publishers. 2015:217-20.
  3. Gifford R, August P, Chesley L. National high blood pressure education program working group report on high blood pressure in pregnancy. Am J Obstet Gynecol. 1990;163:1689-712.
  4. Witlin AG, Sibai BM. Magnesium sulfate therapy in preeclampsia and eclampsia. Obstet Gynecol. 1998;92:883-9.
  5. Refsum H, Ueland PM, Nygard O, Vollset SE. Homocysteine and cardiovascular disease. Ann Rev Med. 1998;49:31-62.
  6. Ingec M, Borecki B, Kadanli S. Elevated Plasma Homocysteine Concentrations in Severe Preeclampsia and Eclampsia. Tohoku J. Exp. Med. 2005;206(3):225-31.
  7. Maladkar M, Sankar S, Awate SA. Hyperhomocysteinemia and Pregnancy complications: Elucidating the role of L-Methylfolate. J South Asian Feder Obst Gynae. 2017;9(4):377-84.
  8. Hoque MM, Bulbul T, Mahal M, Islam NA, Ferdausi M. Serum homocysteine in preeclampsia and eclampsia. Bangladesh Med Res Counc Bull. 2008;34:16-20.
  9. Arun M, Gopinath M, Nirmala C. Prevalence of hyperhomocysteinemia among preeclampsia patients. Journal of Medical Science and Clinical Research. 2017;05(04):21063-9.
  10. Pathania K, Verma SK, Chamotra S, Chaudhary A. Can serum homocysteine predict hypertensive disorders of pregnancy?: An evidence from a case control study in a North Indian tertiary health care institution. Int J Reprod Contracept Obstet Gynecol 2019;8:3117-22.
  11. Chamotra S, Pathania K, Verma SK, Chaudhary A. Predicting pregnancy outcomes from homocysteine level: an evidence from a North Indian study. Int J Reprod Contracept Obstet Gynecol 2020; 9:1498-502.

Corresponding Author

Dr Ankit Chaudhary

District Program Officer, Hamirpur (H.P.)