Role of spot urine albumin-creatinine ratio in predicting pre-eclampsia between 20-28 weeks of gestation

Abstract

Preeclampsia is best characterized as a condition unique to pregnancy that can affect almost any organ system. Appropriate treatment can be given and its effects can be closely monitored. The only widely recognized procedure remains the 24hour urine collection. However, the protracted time involved in sample collection to final reporting in this method, renders it impractical. The current research was therefore aimed at determining the accuracy of the spot urine ratio of albumin-creatinine in asymptomatic pregnant women. Appropriate treatment if started at early stage of the disease helps in closely monitoring of the disease process.A hospital based prospective, observational study was conducted with 150 patients to establish whether a spot urine albumin-creatinine ratio measured between 20-28 weeks gestation could predict pre-eclampsia in asymptomatic pregnant woman in Department of Obstetrics and Gynecology, Kalinga Institute of Medical Sciences and PBM Hospital, Bhubaneswar between September 2018 and April 2020.Of the study group, 28 patients had high ACR value, with 25(89.3%) developed pre-eclampsia and 3(2.4%) remained normotensive whereas among 122 (81.3%) patients that were ACR negative 3 (10.7%) patients developed pre-eclampsia. ACR had a sensitivity of 89.29%, specificity 97.54%, positive predictive value of 89.29% and the negative predictive value is 97.54%.Our analysis showed that in pre-eclampsia patients, urine albumin-creatinine ratio (UACR) values were higher and UACR >35.5 mg / mmol predicted pre-eclampsia well before clinical manifestations started. It is an easy, rapid and reasonably reliable method for predicting and assessing the severity of pre-eclampsia.