DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20196010

A study of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsia

Ruma Sarkar, Shilpi Rawat, Neela Rai Sharma, Harish Chandra Tiwari

Abstract


Background: Preeclampsia is defined as systolic blood pressure level of 140 mmHg or higher or a diastolic blood pressure level of 90 mmHg or higher that occurs after 20 weeks of gestation with proteinuria. Objective of this study was to study the role of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsia

Methods: This is a prospective observational study conducted in the department of obstetrics and gynaecology, BRD Medical College Gorakhpur, since October 2016 to September 2017 included 120 pregnant women with hypertension of gestational age more than 20 weeks. Ramdom urine sample of all the patient was taken before 12 noon after first voiding. For 24 hours urine sample patient was asked to collect all her urine she voids during 24 hours. The creatinine was estimated by the alkaline picrate method (Jaffe's Reaction) modified by the Bonsnes and Taussky, 1945. Creatinine in a protein free solution reacts with the alkaline picrate and produces red colour complex which is measured colorimeterically. Urinary protein was estimated in all the subjects by the Turbidimetric method. Urinary protein was precipitated by 3% sulphosalicylic acid and turbidity so produced was measured colorimetrically.

Results: Protein: creatinine ratio in a random urine sample is better than random urine protein detection by dipstick method in cases of emergency when there is no time for detection of 24 hours urine protein.

Conclusions: If cut-off level for urine protein: creatinine ratio in random urine sample is taken as 0.25 or more then sensitivity and specificity become same as 24 hours urine protein.                                 


Keywords


Eclampsia, Fetal growth restriction, Gestational age, Pedal edema, Pre-eclampsia, Protein: creatinine ratio, 24 hours urine protein

Full Text:

PDF

References


Lindheimer MD, Conrad K, Karumanchi SA. Renal physiology and disease in pregnancy. In Alpern RJ, Hebert SC, (eds): Seldin and Giebisch's the kidney: Physiology and pathophysiology, 4th ed. New York, Elsevier; 2008:2339.

Lindheimer MD, Taler SJ, Cunningham FG. Hypertension in pregnancy. J Am Soc Hyper. 2008;2(6):484-94.

Sibai BM, Stella CL. Diagnosis and management of atypical preeclampsia-eclampsia. Am J Obstet Gynecol. 2009;200(5):481-e1.

Papanna R, Mann LK, Kouides RW, Glantz JC. Protein/creatinine ratio in preeclampsia: a systematic review. Obstet Gynecol. 2008;112(1):135-44.

Dwyer BK, Gorman M, Carroll IR, Druzin M. Urinalysis vs urine protein–creatinine ratio to predict significant proteinuria in pregnancy. J Perinatol. 2008;28(7):461.

Shahbazian N, Hosseini AF: A comparison of spot urine protein- creatinine ratio with 24 hour urine protein excretion in women with pre-clampsia. Iranian J Kidney dis. 2008;2(3):127-31.

Hossain S, Ghosh A, Chatterjee A, Sarkar G, Mondal SS. To evaluate the diagnostic value of protein: creatinine ratio in a single voided urine sample for quantification of proteinuria compared to those of a 24-hour urine sample in patients with pre-eclampsia. J Col Med Sci Nepal. 2013;9(2):45-53.

Khan SM, Parven T, Zulfiquar S. A comparision of spot P/C ratio vs 24 hr urinary protein excretion in women with pre- eclampsia. Int J Obstet Gynaecol Res. 2014;2:67-72.

Aggarwal N, Suri V, Chopra V, Kohli HS. A prospective comparision of random protein/creatinine ratio vs 24 hr urine protein in women with pre-eclampsia. Medscape J Med. 2008;10:98.

Nischintha S, Pallavee P, Ghose S. Correlation between 24-hour urine protein, spot urine protein/creatinine ratio, and serum uric acid and their association with fetomaternal outcomes in pre eclamptic women. J Natu Sci Biol Med. 2014;5(2):255.