A biochemical marker of pre-eclampsia is:-

Appeared in: AIIMS Manglagiri NO - 2019

Explanation

Elevated serum uric acid (hyperuricemia) is a key and early biochemical marker for pre-eclampsia.
This elevation is caused by the disease's impact on the kidneys, specifically a reduced glomerular filtration rate (GFR) and increased tubular reabsorption of uric acid.
The level of uric acid often correlates with the severity of pre-eclampsia and can help in differentiating it from gestational hypertension.

Option A: A raised hemoglobin (Hb) level is not a primary biochemical marker. It can be elevated due to hemoconcentration (loss of plasma volume), which is a sign of severe pre-eclampsia, but it is not specific to the condition.
Option B: Similar to hemoglobin, a raised hematocrit level reflects hemoconcentration from plasma leakage in severe pre-eclampsia. It is a sign of disease severity, not a specific diagnostic marker.
Option C: Electrolyte concentrations typically remain normal in pre-eclampsia. Abnormalities usually only appear with the onset of severe complications like acute kidney injury or HELLP syndrome.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Biochemical markers for pre-eclampsia as background academic context rather than a clinical decision trigger.
Monitoring serum uric acid levels is a valuable tool for nurses and physicians in the early diagnosis and management of pre-eclampsia.
A rising uric acid level in a hypertensive pregnant woman is a red flag that warrants closer maternal and fetal surveillance and may influence the timing of delivery.
What if? If a pregnant patient has new-onset hypertension but her uric acid level is normal, the diagnosis is more likely to be gestational hypertension. However, she still requires close monitoring, as pre-eclampsia can develop later and uric acid levels may subsequently rise.

How to Approach the Question

First, identify the core of the question, which is asking for a specific biochemical marker used to diagnose or monitor pre-eclampsia.
Recall the fundamental pathophysiology of pre-eclampsia: it is a syndrome of vasospasm and endothelial dysfunction that primarily affects the kidneys and placenta.
Evaluate each option in the context of this pathophysiology.
Recognize that raised Hb and hematocrit are related to fluid shifts (hemoconcentration) and are not specific metabolic markers.
Remember that electrolyte balance is generally maintained in uncomplicated pre-eclampsia.
Focus on markers that reflect the specific organ dysfunction seen in pre-eclampsia. Kidney dysfunction is a hallmark.

Concept Tested & Keywords

QWpG7NqIolSgk_Qvamsg2U

E6 Obstetrics Williams p. 7-18

E6 Medicine Harrison 22e Part 2 p. 1803-1805

Practise the full AIIMS Manglagiri NO - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.