A prospective comparative study of urinary calcium creatinine ratio versus doppler study in predicting preeclampsia

Authors

  • Murukuti Mounika Department of Obstetrics and Gynaecology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India https://orcid.org/0000-0002-8793-7765
  • Pottipati Haneesha Department of Obstetrics and Gynaecology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
  • Kameswaramma Department of Obstetrics and Gynaecology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20230135

Keywords:

Preeclampsia, UCCR, Uterine artery PI

Abstract

Background: Hypertensive disorders represent the most common medical complication of pregnancy complicating 5 to 10% of all pregnancies. Several changes have already occurred before the development of clinical syndrome of preeclampsia. One such change occurs in renal function leading to hypo-calciuria. Thus, in present study, urinary calcium creatinine ratio (UCCR) and doppler study are tested as parameters to predict development of preeclampsia in asymptomatic pregnant woman and assessing better predictor among them.

Methods: Hospital based prospective study. Randomly selected pregnant women meeting inclusion and exclusion criteria, will be subjected to detailed history including age, parity, duration of pregnancy, examination including general examination, abdominal examination, routine laboratory investigations, calculate UCCR and ultrasound with doppler study at less than 20 weeks.

Results: Out of 100 women, 25 had UCCR<0.04 and out of which 14 developed pre-eclampsia. Among them 33 had abnormal pulsatility index (PI) at 11-14 weeks and out of which 24 developed pre-eclampsia. In those 100 women, 58 had abnormal PI at 16-20 weeks and out of which 23 developed pre-eclampsia.

Conclusions: Our study shows that we can predict preeclampsia by screening in early weeks of gestation i.e., by uterine artery doppler during NT scan around 11 to 14 weeks and during TIFFA appointment around 16 to 20 weeks and by UCCR. This study shows doppler study prediction is more sensitive and specific compared to UCCR.

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References

Brichant JF, Bonhomme V. Preeclampsia: an update. Acta Anaesthesiology 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 Obstetr. 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, Ismail KM. 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 Hypertension. 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 Obstetr 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 Obstetr Gynecol. 2013;14:2013.

Waugh JJ, Clark TJ, Divakaran TG, Khan KS, Kilby MD. Accuracy of urinalysis dipstick techniques in predicting significant proteinuria in pregnancy. Obstetr 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 Obstetr Gynaecol Reproduct 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. Obstetr Gynaecol Sci. 2013;56(1):8-14.

Begum H, Rahman MN, Ferdous M, Basak SK, Yasmin N, Parveen A. Evaluation of Spot Urinary Calcium to Creatinine Ratio in Preeclampsia: A Cross Sectional Comparative Study. J National Institute Neurosci Bangl. 2017;3(1):14-20.

Fouiza B, Nishitha PA, Prabhachandran P. Evaluation of Urinary Calcium-Creatinine Ratio in Pre-Eclampsia-A Study from Kerala, Southern India. JMSCR. 2017;05(03):18875-82.

Anita V, Adma Harshan S. Urinary Calcium to Creatinine Ratio in Preeclampsia–a Comparative Study. JMSCR. 2017;5-6.

Munge AM, Satia MN. Urinary calcium to creatinine ratio to predict preeclampsia and use of calcium supplementation to prevent preeclampsia. Int J Reproduct Contracep Obstetr Gynecol. 2016;5(5):1380-6.

Ciobanu A, Rouvali A, Syngelaki A, Akolekar R, Nicolaides KH. Prediction of small for gestational age neonates: screening by maternal factors, fetal biometry, and biomarkers at 35-37 weeks’ gestation. Am J Obstetr Gynecol. 2019;220(5):486-e1.

Yamaleyeva LM, Brosnihan KB, Smith LM, Sun Y. Preclinical ultrasound-guided photoacoustic imaging of the placenta in normal and pathologic pregnancy. Molecular Imaging. 2018;17:1536012118802721.

Finn-Sell SL, Cottrell EC, Greenwood SL, Dilworth MR, Cowley EJ, Sibley CP et al. Pomegranate Juice Supplementation Alters Utero-Placental Vascular Function and Fetal Growth in the eNOS−/− Mouse Model of Fetal Growth Restriction. Frontiers Physiol. 2018;9:1145.

Harman CR, Baschat AA. Comprehensive assessment of fetal wellbeing: which Doppler tests should be performed? Curr Opin Obstetr Gynecol. 2003;15(2):147-57.

Saudan PJ, Shaw L, Brown MA. Urinary calcium/creatinine ratio as a predictor of preeclampsia. Am J Hypertens. 1998;11(7):839-43.

David A, Padmaja P. Calcium-to-creatinine ratio in a spot sample of urine, for early prediction of hypertensive disorders of pregnancy: A prospective study. J Obstetr Gynaecol India. 2016;66(1):94-7.

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Published

2023-01-25

How to Cite

Mounika, M., Haneesha, P., & Kameswaramma. (2023). A prospective comparative study of urinary calcium creatinine ratio versus doppler study in predicting preeclampsia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 12(2), 459–464. https://doi.org/10.18203/2320-1770.ijrcog20230135

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Original Research Articles