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EVALUATION OF SERUM UREA, CREATININE AND TOTAL PROTEIN IN PRE-ECLAMPTIC WOMEN ATTENDING ANTENATAL CARE

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Pre-eclampsia is a hypertensive disorder of pregnancy that significantly impacts maternal and fetal health. It is characterized by high blood pressure and often proteinuria, occurring after 20 weeks of gestation in women with no prior history of hypertension (Sibai et al., 2018). Pre-eclampsia affects approximately 2-8% of pregnancies globally, and it is one of the leading causes of maternal and perinatal morbidity and mortality, especially in low- and middle-income countries (Roberts & Hubel, 2019). Understanding the biochemical markers associated with this condition is crucial for early detection, prevention, and management.

Serum urea, creatinine, and total protein are important biochemical markers that are often evaluated in pre-eclamptic women. These markers help assess renal function, which is often compromised in pre-eclampsia. Urea and creatinine are waste products filtered by the kidneys, and elevated levels of these substances can indicate impaired renal function, which is a common complication in pre-eclampsia (Friedman et al., 2020). Total protein levels are also crucial, as hypoalbuminemia is frequently observed in pre-eclamptic women due to increased protein loss in urine (Mohammed et al., 2021). These biochemical changes reflect the severity of pre-eclampsia and can guide clinicians in managing the condition.

The pathophysiology of pre-eclampsia is complex and not fully understood. However, it is widely believed that abnormal placentation and immune maladaptation play critical roles in the development of the condition (Redman et al., 2020). These processes lead to endothelial dysfunction, systemic inflammation, and vascular abnormalities, which in turn affect renal function and protein metabolism (Shennan et al., 2019). As a result, the measurement of serum urea, creatinine, and total protein levels can provide valuable insights into the extent of organ dysfunction in pre-eclamptic women.

Several studies have explored the clinical utility of monitoring these biochemical markers in the management of pre-eclampsia. For instance, a study by Wang et al. (2019) demonstrated that elevated serum urea and creatinine levels were associated with adverse maternal and fetal outcomes in pre-eclamptic women. Similarly, low total protein levels were linked to severe forms of the condition and increased risk of complications (Rodríguez et al., 2021). These findings underscore the importance of regular biochemical monitoring in pre-eclamptic women to prevent complications and improve maternal and fetal outcomes.

In many low-resource settings, where access to advanced diagnostic tools may be limited, the evaluation of serum urea, creatinine, and total protein levels can serve as an affordable and accessible method for assessing the severity of pre-eclampsia (Adekanbi et al., 2020). This is particularly important in sub-Saharan Africa, where pre-eclampsia is a major contributor to maternal mortality (Say et al., 2018). Routine screening of these biochemical markers during antenatal care can help in the early identification of high-risk pregnancies, enabling timely interventions to reduce the burden of the disease.

Furthermore, the evaluation of serum urea, creatinine, and total protein levels in pre-eclamptic women attending antenatal care can provide insights into

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