Serum uric acid levels as an index of fetal prognosis in pregnancies complicated by pre-existing hypertension and pre-eclampsia of pregnancy.

The relation of perinatal mortality to plasma-urate concentration and blood pressure was studied in 200 patients with pre-existing hypertension and 200 patients with pre-eclampsia of pregnancy. Perinatal mortality was markedly increased when maternal plasma-urate concentrations were raised, generally in association with severe pre-eclampsia of early onset or superimposed on pre-existing hypertension. Maternal hypertension, even severe, without hyperuricemia was associated with good prognosis for the fetus. When there was hyperuricemia, the prognosis for the fetus was poor irrespective of the level of blood pressure. Pre-eclampsia of pregnancy was associated with high perinatal mortality rate when compared with the rate in pre-existing hypertension. This study suggests that serum urate is a reliable index of fetal welfare when pregnancy is complicated by pre-eclampsia and pre-existing hypertension.