The value of measuring plasma
urate and serum
deoxycytidylate deaminase (
dCMP deaminase) for the early diagnosis of
pre-eclampsia has been investigated in 45 patients. A combination of increased blood pressure and increased plasma
urate identified 19 patients with a high incidence of fetal and maternal morbidity ascribable to
pre-eclampsia. Seventeen of the 19 patients also had an increased serum
dCMP deaminase. Serial antenatal observations for a mean period of 104 days (36-179 days) on 33 of the patients demonstrated that plasma
urate and serum
dCMP deaminase increased together as early changes in the development of
pre-eclampsia. In six patients, blood pressure, plasma
urate and serum
dCMP deaminase all increased but in only one was the rise in blood pressure the first change. Elevations of plasma
urate and serum
dCMP deaminase are therefore both early features of
pre-eclampsia. Serial measurements can give warning of the disorder before the appearance of other clinical features. The change in
dCMP deaminase is probably another reflection of early renal involvement in the pre-eclamptic process.