Comparative evaluation of different methods to quantify proteinuria in preeclampsia
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20223131Keywords:
Dip stick test, Preeclampsia, Proteinuria, Sulphosalicylic acid (SSA), Urine protein-creatinine ratio (PCR)Abstract
Background: Worsening of condition in preeclampsia is indicated by progressive proteinuria, hence its quantification helps in decision making and plan treatment accordingly. The present study was undertaken to compare different methods of estimation of proteinuria to find best method for quantification.
Methods: It was a hospital based prospective study conducted on a group of 100 pregnant women diagnosed as preeclampsia after 20 weeks of gestation, they were subjected to different methods of quantification of proteinuria after admission in department of obstetrics and gynaecology, Narayana medical college and hospital, Nellore over a period of one year.
Results: Present study showed strong positive strength of association of SSA test was higher compared to the spot urinary PCR and spot urinary dipstick. To assess the predictability of three methods compared against 24-hour urine protein estimation by ROC curve. The AUC of the SSA test and spot urinary PCR was stronger than the urinary dipstick. Study showed a significant better method as SSA>>Urinary PCR>>dipstick with accuracy of 96.04%, 95.0% and 54% respectively.
Conclusions: This study concluded that spot urine SSA and urine PCR are reliable investigations compared to dipstick method. So, spot urine SSA and urine PCR can be used for detection of proteinuria in pregnant women with pre-eclampsia with high accuracy, which is more rapid than time consuming 24-hour urine protein estimation. Thus, this quick method with high accuracy is very useful to prevent feto-maternal morbidity and mortality in India.
References
Brichant JF, Bonhomme V. Preeclampsia: an update. Acta Anaesthesiol Belg. 2014;65(4):137-49.
Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre‐eclampsia: a pragmatic guide for first‐trimester screening and prevention. Int J Gynecol Obstet. 2019;145:1-33.
August P, Sibai BM. Preeclampsia: clinical features and diagnosis. Post TW, UpToDate. Waltham, MA: UpToDate; 2017.
Thangaratinam S, Coomarasamy A, O’Mahony F, Sharp S, Zamora J, Khan KS, et al. Estimation of proteinuria as a predictor of complications of preeclampsia: a systematic review. BMC Med. 2009;7(1):1-9.
Amin SV, Illipilla S, Hebbar S, Rai L, Kumar P, Pai MV. Quantifying proteinuria in hypertensive disorders of pregnancy. Int J Hypertens. 2014;2014.
Kumari A, Singh A, Singh R. Evaluation of rapid diagnostic methods of urinary protein estimation in patients of preeclampsia of advanced gestational age. J Obstet Gynaecol India. 2013;63(5):306-10.
Sharma A, Kiran P, Aja B. Spot urine protein/creatinine ratio- A quick and accurate method for diagnosis of pre-eclampsia. Open J Obstet Gynecol. 2013;2013.
Waugh JJ, Clark TJ, Divakaran TG, Khan KS, Kilby MD. Accuracy of urinalysis dipstick techniques in predicting significant proteinuria in pregnancy. Obstet Gynecol. 2004;103(4):769-77.
Kayatas S, Erdogdu E, Cakar E, Yılmazer V, Arınkan SA, Dayıcıoglu VE. Comparison of 24-hour urinary protein and protein-to-creatinine ratio in women with preeclampsia. Eur J Obstet Gynaecol Reprod Biol. 2013;170(2):368-71.
Park JH, Chung D, Cho HY, Kim YH, Son GH, Park YW, et al. Random urine protein/creatinine ratio readily predicts proteinuria in preeclampsia. Obstet Gynaecol Sci. 2013;56(1):8-14.
Berthet A, Bartolo S, Subtil D, Clouqueur E, Garabedian C, Azaïs H. Spot urine protein‐to‐creatinine ratio as a diagnostic test in pre‐eclampsia: A gold standard? Int J Gynecol Obstet. 2020;149(1):76-81.
