The Role Of Serum Electrolytes In Pregnancy Induced hypertension

Background and Objectives: Pregnancy Induced Hypertension (PIH) is one of the most common complications of pregnancy and it contributes significantly to the maternal mortality, premature birth, intra uterine growth retardation (IUGR) and perinatal mortality. The study of electrolytes is gaining ground in the pathophysiology of hypertension. Multiple strategies have been proposed and evaluated for the prevention and management of PIH, which include the moderate dietary restriction of sodium and the administration of magnesium and calcium. Methods: Our study consisted of 50 normal non-pregnant women, 50 normal primigravida in the second or third trimester of pregnancy and 50 pregnant women with PIH. The present study was undertaken to evaluate the serum ionized calcium, magnesium, sodium and potassium levels in PIH and to find out if the deficiency of these electrolytes was a predisposing factor in the genesis of PIH. Results: There was a linear fall in serum ionized calcium, magnesium and sodium levels in the normal pregnancy cases as compared to those in the non-pregnant controls (P<0.001), with a further significant fall in the PIH cases as compared to the normal pregnancy cases (P<0.0001). There was no significant change in the potassium levels in the PIH cases as compared to those in the normal pregnancy cases (P<0.457). A decreased calcium intake leads to an increase in the parathyroid hormone, which increases intracellular calcium, thus leading to an increase in the vascular smooth muscle contraction and thus, an elevation in the blood pressure. Low levels of magnesium and sodium cause hypocalcaemia, which in turn increases the blood pressure. Thus, along with a moderate dietary restriction of sodium, a dietary supplementation of calcium and magnesium in the form of milk, cheese, soybean products, leafy vegetables, etc. during pregnancy, could result in a reduction in the incidence of PIH.