1.0 INTRODUCTION
Pre-eclampsia is defined as the presence of systolic blood pressure (SBP) greater than or equal to 140mmHg and diastolic blood pressure(DBP)greater than or equal to 90mmHg (Jameil et al., 2014). Pre-eclampsia is a multisystem disorder affecting several organs and maternal systems including the vascular system, liver, kidney and brain (Steegers et al., 2010). It is a complication of pregnancy that contribute to both maternal and fetal problems.
Pre-eclampsia is also characterized by the presence of protein in urine called proteinuria. The disorder affects about 2-4% of pregnancies (Lana et al., 2004). Despite the intensive research in this area, the etiology of pre-eclampsia remains unknown. It seems to have a multifactorial cause and is also known as the “disease of theories”. There are several signs and symptoms which are associated with pre-eclampsia. Although these signs and symptoms are not usually specific for pre-eclampsia, they share almost the same signs and symptoms with pregnancy which are swelling, pitting edema, convulsion, epigastric pain (Jameil et al., 2014). The causes of pre-eclampsia maybe genetic, immune placental and other factors.
Proteins are large molecules made up of Amino acids bonded together by peptide bond (Chatterjea and Rana, 2012). All proteins have carbon, Hydrogen, oxygen, nitrogen and sulphur. These are essential in their structure. There are numerous sources of proteins like milk, egg, beans etc. There are so many classes of proteins. E.gs. of some proteins include Albumin, globulin, lipoproteins etc. In Pre-eclampsia, there are usually presence of protein in urine. Normally protein being a large molecule is not supposed to be found in urine, because of the damage of the glomeruli of the kidney in a pre-eclamptic patient, there are usually presence of protein in urine. (Neithardt et al., 2002). Therefore in a pre-eclamptic patient, there are usually decreased protein (albumin, globulin and total protein). Also because of the phenomenom of hemodilution and increased demand of the developing fetus, serum albumin decreases during all the trimesters in a pre-eclamptic patient (Harold et al., 2006).
Bilirubin is a product formed from the breakdown of hemoglobin in the Red blood cells of the liver, spleen, bone marrow and reticuloendothelial system (RES). This occurs after 120 days because red blood cells have a life span of 120 days (Nwanjo, 2006). Oxidative stress is involved in the pathogenesis of pre-eclampsia. This is as a result of increased production of oxidizing agents that is not counteracted by antioxidant. Bilirubin is a non-enzymatic antioxidant and it also helps to counteract the ROS (Reactive oxygen species) and RNS (reactive nitrogen species) produced during oxidative stress in pre-eclampsia. Therefore there are usually increased levels of Bilirubin in pre-eclampsia. This is because there is usually increased breakdown of RBC in a pre-eclamptic patient (Raijmakers et al., 2004).
Lipids are large and diverse group of naturally occurring organic compounds that are related by their solubility in non-polar organic solvents (Swapnali et al., 2011). Lipid profile is a blood test done in other to assess the status of fat metabolism in the body and its importance in heart disease. This includes measuring lipids and its derivatives called lipoproteins (HDL, LDL, TG). It is usually performed with a fasting specimen (Zhang et al., 2014). The physiological hyperlipidemia observed in healthy pregnant women is further exacerbated in pre-eclampsia (Ray et al., 2006). Pre-eclampsia is characterized by intense changes of lipid profile. According to Bayhan et al., (2005) there is an increase in TG, LDL-C and total cholesterol but a decrease in HDL-C.
Pre-eclampsia is a pregnancy specific disorder characterized by an impaired blood perfusion of vital organs including the fetal-placental unit. The prevalence of pre-eclampsia although usually reported as 4%-8% presents some variations in the literature particularly for different populations (Sibai et al., 2015; Maynard et al., 2010). Several studies indicate that pre-eclampsia is associated with a higher incidence of newborns with low birth weight (Groom et al., 2007; Duley, 2009; Wu et al., 2009). Some neonatal complications resulting from pre-eclamptic pregnancy are described and are associated with prematurity including Jaundice, respiratory distress, apnea, seizures, hypoglycaemia and prolonged hospitalization (Duley, 2009; Wu et al., 2009).
The changes of total protein, albumin, bilirubin and lipid profile (HDL.C, LDL.C, TC and TG) are worth assessing for in pre-eclamptic patients. Moreover, there is paucity of published work on the aspect of total proteins, albumin, bilirubin and lipid profile in pre-eclamptic patients in Nigeria. However, the intensity of pre-eclampsia, socio-economic and cultural practices vary in various parts of the country. This work is expected to address the paucity of information on the molecular dynamics of pre-eclampsia and prevention with a view to provoking further research especially in the area of diagnosis, management, and prevention.
To estimate the levels of Total protein, Albumin, Bilirubin and Lipid profile in pre-eclamptic patients in Imo Specialist Hospital Umuguma,Owerri.