Investigating hemolysis, elevated liver enzymes and low platelet count in preeclampsia: A case-control study in Ghana.

Autor: Akilla MA; Department of Biomedical Laboratory Science University for Development Studies Tamale Ghana., Nchor Awinibuno IA; Department of Biomedical Laboratory Science University for Development Studies Tamale Ghana., Banyeh M; Department of Biomedical Laboratory Science University for Development Studies Tamale Ghana., Mayeem BN; Department of Medical Laboratory Living Waters Hospital Kumasi Ghana., Kwofie GS; Department of Family Medicine Living Waters Hospital Kumasi Ghana., Adoko S; Department of Clinical Diagnostics Shalina Diagnostics Kumasi Ghana., Nukpezah RN; Department of Preventive Health Nursing University for Development Studies Tamale Ghana., Kolekang AS; Department of Epidemiology, Biostatistics and Disease Control University for Development Studies Tamale Ghana., Dagungong CB; Department of Biomedical Laboratory Science University for Development Studies Tamale Ghana., Amidu N; Department of Clinical Chemistry University for Development Studies Tamale Ghana.
Jazyk: angličtina
Zdroj: Health science reports [Health Sci Rep] 2024 Jul 29; Vol. 7 (8), pp. e2277. Date of Electronic Publication: 2024 Jul 29 (Print Publication: 2024).
DOI: 10.1002/hsr2.2277
Abstrakt: Background and Aims: Preeclampsia poses a heightened risk for women, particularly in the development of hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, leading to adverse outcomes for both mothers and newborns. The incidence of HELLP syndrome tends to be notably higher among women with preeclampsia compared with those with normotensive pregnancies. However, there is a dearth of research on the frequency of HELLP syndrome within the context of preeclampsia specifically in Ghana. Furthermore, the potential predictive value of serum erythrocyte adenylate kinase (EAK), a marker of hemolysis, in anticipating the onset of preeclampsia remains largely unexplored.
Methods: Conducted between May 2020 and April 2022, this research employed a case-control methodology at the War Memorial and Upper East Regional Hospitals. A total of 291 pregnant women participated, comprising 111 diagnosed with preeclampsia and 180 control subjects, aged between 18 and 43 years. Venous blood samples were collected and subjected to analysis for platelet count, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and EAK, utilizing automated analyzers, alongside the ELISA technique. Diagnosis of HELLP syndrome was established using the Mississippi triple-class definition.
Results: The median serum ALT level (with interquartile range) was significantly elevated in the preeclampsia group compared with controls [20.0 (13.7-27.0) vs. 13.0 (9.4-18.6); p  < 0.001]. Moreover, the frequency of Mississippi class 3 HELLP syndrome was notably higher among preeclampsia cases (2/111; 1.8%) compared with controls (1/180; 0.6%). Serum ALT emerged as the superior predictor of preeclampsia, outperforming LDH (with an area under the curve of 0.73 compared with 0.58). The sensitivity and specificity of ALT were measured at 47.8% and 87.2%, respectively.
Conclusion: Although the occurrence of HELLP syndrome in preeclampsia cases appears relatively low, it may escalate as the prevalence of preeclampsia is anticipated to rise in low and middle-income nations.
Competing Interests: The authors declare no conflict of interest.
(© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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