Correlation between plasma fibronectin level and renal function in pregnant women with

Background:- Worldwide, pre-eclampsia and eclampsia contribute to the death of a pregnant woman every three minutes((Emillja, 2011). Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality. Although the exact pathogenesis of preeclampsia still remains to be unrivalled and is most likely multifactorial; it is increasingly clear that pathological processes at the interface of the fetal and maternal circulation leading to generalized endothelial cell dysfunction contribute to the spectrum of the disease . The signs and symptoms of the disease are well recognized and they characteristically manifest in the second to third trimester, although the underlying pathology is present at earlier stages of pregnancy. The identification of reliable screening markers that could predict the subsequent onset of preeclampsia before maternal clinical manifestations become apparent would permit major improvements in obstetric care through better targeting of antepartum surveillance. Objectives:- The purpose of this study was to examine plasma fibronectin levels and serum renal function test throughout normotensive pregnancy and preeclampsia and to analyze their predictive values for the detection of preeclampsia within the second and third trimester of pregnancy. Methods:- Case control study in which Blood samples were collected from 50 healthy pregnant women and 50 Preeclamptic women. Plasma samples were assayed for fibronectin by enzyme-linked immunosorbent assay and measurement of uric acid, uria nitrogen and serum creatinine by continuous segmented flow analyzer Results:- In both groups, fibronectin levels rose as pregnancy advanced, but in women with preeclampsia, this increase was significantly higher (P = 0.0001). Throughout pregnancy, patients with preeclampsia exhibited significantly higher serum uric acid, than did control subjects. A difference was established (preeclampsia, 7.5±0.9; control, 3.2±0.44mg/dl [mean ± SEM]; P = . 0.001. The best cutoff point and time interval to calculate predictive values for plasma fibronectin were 444 mg/dl. Sensitivity, specificity, and positive and negative predictive values were 98%, 100%, 100%, and 98%, respectively. Conclusion:- In women in whom clinical preeclampsia developed, endothelial damage seemed to be present since early gestation through early changes in some biochemical indicators during early pregnancy . Plasma fibronectin levels of ?444 ?g/mL may help in the early detection of preeclampsia in healthy nulliparous women. Also serum uric acid could help in early detection of preeclampsia.