الفهرس 
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Abstract
The objective of this study is to measure the concentrations of serum uric acid and lipids (Cholesterol, TG, LDL-c, HDL-c) in healthy nulliparous women in mid-second trimester, and follow up the pregnancy outcome. The predictive values of these metabolic markers for adverse pregnancy outcome are analyzed.
This study included 500 nulliparous women attending at Antenatal Outpatient Department (OPD) of Benha Teaching Hospital, Minia El-Kamhe Hospital and Meit Sehal Medical Center. The study was conducted on October 2013 till August 2018.Gestational age was estimated by reliable Last Menstrual Period (LMP) that was confirmed or corrected by ultrasound scanning.
We put all data of 500 women in sheets
All women were followed up routinely till the end of pregnancy and delivery.
Results: Women who developed preeclampsia late in pregnancy had significantly lower median HDL c in mid-second trimester (p=0.001)with significantly higher UA(p=0.001)and TG (P=0.001).No significant difference was detected in TC and LDL c levels between preeclampsia group and non-preeclampsia group.
At 20 weeks gestation, high levels of TG,UA and low levels of HDL-c were independently associated with development of PE, with (OR 2.42,3.09 and 2.34) respectively. With ROC curve analysis, UA was a predictor for PE with sensitivity of 88.2% and specificity of 84.3%.
Also women who developed GDM late in pregnancy had a significant lower median HDL c in mid -second trimester (P=0.001), while they had significantly higher TG (P=0.004) and uric acid (P=0.001).No significant difference was detected in TC and LDL c among women with GDM. Validity of uric acid in GDM shows an AUC of ( 0.977), sensitivity of 100% and specificity of 92.6% combining it with the results of lipid profile the specificity increased to 95.8%.
There is a statistically significant difference between women delivered preterm and term regarding BMI and HDL-c. They showed significantly lower BMI and lower HDL-c levels.
The present data suggest that the relation-ship of hypertriglyceridemia, hyperuricemia, and hypo-HDL-cholesterolemia at 20 weeks of gestation did indicate that metabolic status may be associated with adverse pregnancy outcomes. Measuring lipids and uric acid in mid-second trimester can be used in predicting adverse pregnancy outcome.
An association between maternal early pregnancy elevated Triglycerides (TG) and uric acid and lowered HDL c carry a the subsequent risk of PE and GDM. The occurrence of pre-eclampsia, gestational diabetes,and preterm deliveries cannot be predicted based on the values of serum cholesterol and low-density lipoprotein cholesterol (LDL-c).
Triglycerides (TG) greater than 145 mg/dl, HDL-c lower than 36 mg/dl and uric acid greater than 3.92 mg/dl in the second trimester can predispose pregnant females to develop preeclampsia,(PE).Triglycerides (TG) greater than 99mg/dl, HDL-c less than 40mg/dl and uric acid more than 4.84 mg/dl in the second trimester can predispose pregnant females to develop Gestational diabetes mellitus (GDM).High-density lipoprotein cholesterol (HDL-c) lesser than 54.89mg/dl in the second trimester can predispose pregnant females to develop preterm deliveries.