Gestation, Severity of Hypertensive Disorders and Serum, Urinary, Calcium

Studies have supported and negated hypothesis, that hypocalcaemia is associated with hypertensive disorders of pregnancy (HDsP), mechanism is probably cellular. So serum and urinary levels do not reveal facts. Objective: Study was carried out to know relationship between serum calcium, urinary calcium, fetomaternal outcome, with early onset (EO), late onset (LO) HDsP. Materials and methods: Study subjects with singleton pregnancy beyond twenty weeks, diagnosed as gestational hypertension (GH), preeclampsia, eclampsia, over two years, were divided into EO (≥ 20 to <34 weeks gestation), LO (≥ 34 weeks), subdivided, category A (≥ 20 to <28 weeks), B (≥ 28 to <34 weeks), C (≥ 34 to <37 weeks), D (≥ 37 weeks), serum calcium, 24 h urinary calcium were measured. Pregnancy outcome was recorded. Results: In EO HDsP, 11.07% had mild GH, of them 53.3% and in LO 38.97% had mild GH, of them 27.48% had hypocalcaemia. Amongst severe PE, of category A 55%, B 58.33%, C 40%, D 41% had hypocalcaemia. Mean serum calcium in A was 8.13 mg/dl, B was 8.15 mg/dl, C was 8.25%, D was 8.28 mg/dl, low in EO, but insignificant difference. Mean 24 h calciuria in A was 114.5 mg/24 h, B, 110.6 mg/24 h, significantly more than LO, 101.34 mg/24 h in C, 89.45 mg/24 h in D. Mean 24 h calciuria was significantly low in LO. In A 36 (45.0%) of 80 patients had hypocalcaemia, 6 (16.8%) of them had spontaneous preterm births, in B, of 191 patients, 106 (55.50%) had hypocalcaemia, spontaneous preterm births in 16.9%. In LO of 475 of C, 190 (40.0%) had hypocalcaemia 6.8% had spontaneous preterm births, significantly less than EO, though had hypocalcaemia. Conclusion: Serum calcium was lower in EO than LO but difference insignificant. Many HDsP had hypocalciuria, mean 24 h calciuria was significantly more in EO compared to LO, difference in A, D significant. Studies are required to investigate further.

Author(s): Shakuntala Chhabra and Anupriya Singh

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