Plasma-urate measurements in predicting fetal death in hypertensive pregnancy.

The relation of perinatal mortality to plasma-urate concentrations and blood-pressure was studied in 332 pregnant patients with hypertension. Perinatal mortality was markedly increased when maternal plasma-urate concentrations were raised, generally in association with severe pre-eclampsia of early onset. Plasma-urate was a better indicator than blood-pressure of prognosis for the fetus. Maternal hypertension, even severe, without hyperuricaemia, was associated with an excellent prognosis for the fetus. Conversely, when maternal hypertension was mild and hyperuricaemia was severe, the prognosis for the fetus was poor. These findings suggest that, in terms of fetal health, changes in renal handling of urate may be a more important feature of pre-eclampsia than the hypertension.