Laboratory testing for preeclampsia: Result trends and screening recommendations

To better direct screening for preeclampsia, we describe the result trends of the laboratory tests used in the workup of preeclampsia at our instituti on. The clinical characteristics of patients with abnormal test results are further detailed. The objective of the study is to recommend a laboratory screening regimen for preeclampsia based on the data. All patients who deli vered at National Naval Medical Center from February to July 1996 who had b lood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotr ansferase, or uric acid determinations as part of a workup for preeclampsia mere identified. Results are reported, and the clinical characteristics of patients with abnormal tests were obtained from the medical record. Abnorm alities of uric acid and liver enzymes were few in our patient population ( 6% and 7%, respectively). The majority of patients with abnormal uric acid and liver function tests had the classic clinical symptoms of preeclampsia; therefore, the laboratory data added little to the clinical diagnosis. The re was a high rate of renal test abnormalities, necessitating further inves tigation. We recommend omitting liver function and uric acid testing in the routine screening for preeclampsia, The high incidence of abnormal renal t ests warrants continued use of this screening test and, more importantly, f urther investigation into the relationship between abnormal renal tests and disease course.