Liver and kidney function tests in normal and pre-eclamptic gestation: A comparison with non-gestational reference values

Abstract

Objective: To compare liver and kidney function tests in pre-eclampsia and in uncomplicated pregnancy and to relate the results to physiological reference values. Design: Prospective cross sectional study. Setting: Antenatal clinic and antenatal labour wards. Harare Hospital, Zimbabwe. Subjects: 38 pre-eclamptic and 72 normal women of similar parity, gravida and gestational age. Main Outcome Measures: Serum albumin, total bil irubin, alkaline phosphatase (ALP), aspartate transaminase (AST), alanine transaminase (ALT) and gamma-glutamyl transaminase (GGT) were used as indices of hepatic function. Serum creatinine, urea and uric acid were used to assess renal function. Results: Albumin, bilirubin and ALT did not show any differences between the pre-eclamptic and normotensive pregnant women. The activities of the following enzymes, ALP (p<0.001), AST (p=0.001) and GGT (p<0.01) were significantly elevated in pre-eclamptic women. The renal indices, creatinine, urea and uric acid were significantly raised in pre-eclampsia (p<().()() 1). No significant differences were observed in the haematological parameters, haemoglobin (Hb), white blood cell count (WBC), red blood cell count (RBC), mean corpuscular volume (MCV) and platelet count. Almost all the biochemical and haematological parameters were lower in normal pregnancy compared to the physiological reference values used in our maternity unit. Conclusion: Liver and kidney function is modified by normal pregnancy. However, the majority of the liver and kidney function tests between pre-eclamptic and normal pregnancy exhibited significant differences. The physiological reference values that are currently in use are different from those of women with uncomplicated pregnancies and may not be entirely suitable for management of pre-eclampsia which has hepatic and renal involvement.