Background: Pre-eclampsia has significant impacts on maternal and fetal health. It is a leading cause of maternal mortality in both developed and developing countries. Early prediction of the disease would help in determining those patients who were more likely to benefit from interventional measures. Objective: to evaluate association of some serum biomarkers (calcium, creatinine, and uric acid) to severe pre-eclampsia. Patients and methods: 50 apparently healthy primigravidae of attendants of antenatal care clinic of the department of obstetrics and gynecology, Al-Azhar University, Assiut- Egypt, during the period from January 2019 till July 2019 were recruited for the study, 25 normal pregnant women as controls (group I) and 25 pregnant women who developed severe pre eclampsia (group II) later during follow up . The blood samples were collected and analyzed for serum calcium, creatinine and uric acid level during booking visit and repeated later in third trimester or when suspicious signs or symptoms developed during ANC visits. Results: serum calcium levels was significantly lower (7.93± 0.12mg/dl vs. 8.76 ± 0.22 mg/dl, p <0.05 for severe pre-eclampsia and control groups respectively), serum uric acid were significantly higher (7.42± 1.35mg/dl vs. 5.12 ± 1.34mg/dl, p < 0.001 for both groups respectively), serum creatinine was statistically non significant between both groups (p>0.05). Conclusion: hypocalcaemia and hyperurecimia were associated with pre-eclampsia and might be attributed to the development and progression of the disease. Recommendation: Low serum Ca and elevated uric acid levels can be used as early predictors for severe preeclampsia
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