Abstract
Introduction: Hypertensive disorder in pregnancy complicates around 5 to 10% of all pregnancies. It is one of the leading causes of maternal and fetal morbidity and mortality. Measurement of protein excretion by 24 -hour urine protein collection is gold standard but as it is time consuming, an alternative method like random urine protein/creatinine ratio is required.Objectives: The aim of this study was to assess the diagnostic accuracy of urine protein/ creatinine ratio compared with 24-hour urine protein as an alternative method for evaluating proteinuria in preeclampsia.Methodology: Patients with preeclampsia after 20 weeks of gestation were included in the study. Random urine protein/ creatinine ratio and 24-hour urine for protein was collected and evaluated for proteinuria. Results were entered and analysis was done.Results: Fisher's exact test depicted a positive association between UPCR with 24-hour urine protein, p value being less than 0.05. The area under curve was calculated as 0.87 95% CI (0.74-1.01), which was statistically significant. At cut off point of 0.3, sensitivity was 100%, specificity 90%, positive and negative predictive value 97.2% and 100% respectively.Conclusion: Random urine protein/ creatinine ratio (>0.3) is a reliable indicator of proteinuria >300mg/day. It can be used as an alternative to 24-hour protein estimation. BJHS 2018;3(1)5 : 350-353
Highlights
Hypertension is diagnosed when systolic blood pressure is 140mm Hg or more and diastolic is 90mmHg or more a er 20 weeks of gesta on in a previously normotensive woman
Objec ves The aim of this study was to assess the diagnos c accuracy of urine protein/ crea nine ra o compared with 24-hour urine protein as an alterna ve method for evalua ng proteinuria in preeclampsia
Random urine protein/ crea nine ra o (>0.3) is a reliable indicator of proteinuria >300mg/day. It can be used as an alterna ve to 24-hour protein es ma on
Summary
Hypertension is diagnosed when systolic blood pressure is 140mm Hg or more and diastolic is 90mmHg or more a er 20 weeks of gesta on in a previously normotensive woman. Hypertensive disorder in pregnancy complicates around 5 to 10 percent of all pregnancies. It is one of the deadly causes that contributes to maternal morbidity and mortality.[1]. The commonly performed techniques for es ma ng proteinuria are qualita ve dips ck test, the quan ta ve 24-hour protein and protein/crea nine ra o of a single voided urine specimen. Abnormal protein excre on is defined as persistent dips ck 30mg/dl(1+), 24-hour urine protein exceeding 300mg and protein/crea nine ra o >0.3.1 Urine dips ck test despite being easy to perform has low sensi vity and specificity and is influenced by various factors like maternal hydra on, presence of the infec on, exercise.[3] Urine dips ck is a poor predictor of the 24-hour urine total protein level.[4,5]
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