Role of Cord Blood Ischemia Modified Albumin in Normal Pregnancies and Pre-Eclampsia

Hypertensive disorders of pregnancy (which include pre-eclampsia) are one of the most common
causes of death due to pregnancy. Pre-eclampsia is defined as hypertension (systolic blood
pressure>140 mmHg, diastolic blood pressure >90 mmHg) after gestation of 24 weeks along with
proteinuria (urine protein concentration >300 mg in 24 h sample. Pre-eclampsia increases the risk of
poor outcomes for both the mother and the baby. If left untreated, it may result in seizures at which
point it is known as eclampsia. During acute ischemic conditions, the metal‐binding capacity of
albumin to transition metals such as copper, nickel, and cobalt is reduced, leading to the generation of
a metabolic variant of the protein, commonly known as ischemia‐modified albumin (IMA).
Preeclampsia is characterized by poor placental perfusion due to vasospasm of uterine spiral arteries.
It is associated with ischemia and increased oxidative stress, which may lead to modification of
plasma albumin to ischemia modified albumin. IMA measurement has recently been proposed as a
sensitive marker for the diagnosis of myocardial ischemia but it has been reported to be associated
with other conditions also where ischemia is involved. Reports on estimation of cord blood IMA in preeclampsia
are quite sparse and this chapter aims to analyze the role of IMA in cord blood of preeclamptic
patients.