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Uric acid: is it time to give up routine testing in management of pre-eclampsia?
Vikram Sinai Talaulikar1, Hassan Shehata2
1Department of Obstetrics & Gynaecology, St George's Hospital and Medical School , Cranmer Terrace, Tooting, London SW17 0RE.
Insights
Routine uric acid testing in pregnancies with hypertensive disorders is not recommended. Evidence shows it lacks a definitive role in predicting, diagnosing, or managing pre-eclampsia, and stopping this practice offers significant cost savings.
Area of Science:
- Obstetrics and Gynecology
- Clinical Chemistry
Background:
- Uric acid has been historically associated with pre-eclampsia pathophysiology.
- It has been routinely tested for nearly a century in pregnancies with hypertensive disorders.
Purpose of the Study:
- To evaluate the definitive role of uric acid testing in the prediction, diagnosis, and management of pre-eclampsia.
- To argue against the routine use of uric acid testing in hypertensive pregnancies.
Main Methods:
- Review of existing evidence on uric acid's role in pre-eclampsia.
- Clinical and economic analysis of routine uric acid testing.
Main Results:
- Current evidence suggests uric acid testing has no definitive role in pre-eclampsia.
- Routine testing represents a potentially fruitless academic exercise.
Conclusions:
- Routine uric acid testing should cease in pregnancies complicated by hypertension.
- Discontinuing routine testing will lead to significant cost savings for health services.
Abstract:
Ever since it was first linked with the pathophysiology of pre-eclampsia, uric acid has been a routine test requested by many care-givers managing pregnant women with hypertensive disease of pregnancy for almost 100 years. Existing evidence however suggests that it has no definitive role in prediction, diagnosis or management of pre-eclampsia. We argue against routine uric acid testing in pregnancies complicated by hypertension not only because it has become a fruitless academic exercise but also because ceasing its routine use will ensure cost-savings for the health services.
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