Madhumitha, T K (2017) Spot Urine Protein-Creatinine Ratio and 24 hour Urine Protein Excretion in Women with preeclampsia: A Comparative study. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION: Hypertensive disorders, the commonest medical disorder during pregnancy affects 7-15% of all gestations and account for approximately a quarter of all admissions in antenatal ward. According to World Health Organization’s systemic review on maternal mortality worldwide, hypertensive disease remains a leading cause of direct maternal mortality. Together with haemorrhage and infection, hypertension forms the deadly triad that contributes to morbidity and mortality during pregnancy and childbirth. Preeclampsia contributes a greater risk, complicating approximately 5 – 8 % of all pregnancies. Preeclampsia is a disease process involving multiorgans of unknown aetiology characterized by de novo onset of hypertension and proteinuria after 20 weeks of gestation, sometimes progressing into a multiorgan cluster of varying clinical features. It is a syndrome specific to pregnancy that can affect every organ system. AIM OF THE STUDY: To know if spot protein creatinine ratio would provide accurate quantification of proteinuria compared with 24 hour urine protein excretion in women with preeclampsia. METHODS: Spot urine protein creatinine ratio was determined in midstream urine sample and 24 hours protein excretion was measured on the subsequent day and were correlated and diagnostic cut off value was determined. RESULT: A strong correlation was observed from r=0.469 with p<0.001. Optimal cut-off value was 0.30 with 95.7% sensitivity and 90.5% specificity. CONCLUSION: Spot urine P/C ratio may be a quick, convenient and accurate diagnostic test of significant proteinuria in preeclamptic patients. CONCLUSION: Since the urinary protein excretion level has important clinical implications in the course of pregnancy, it is necessary to detect earlier even the smaller degrees of hyperproteinuria. Dipstick analysis as a screening for proteinuria lacks reliability due to higher rate of false positives. For years, 24 hour urine collection has been the gold standard to quantify proteinuria in managing a preeclamptic women. However, this method of quantification is inconvenient, cumbersome,incomplete due to collection errors, needs good compliance from the patient and results in the delayed diagnosis of > 24 hours till the time of collection. The value of the protein/creatinine ratio in a single random urine sample has potentially greater accuracy, as it avoids collection errors and gives us more physiologically relevant information. Cost effectiveness and acceptability by the patient with good compliance makes spot protein creatinine ratio as an effective alternative in quantitating proteinuria.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | proteinuria, protein/creatinine ratio, 24 hour urine protein, pre-eclampsia. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Devi S |
| Date Deposited: | 20 Mar 2020 03:17 |
| Last Modified: | 20 Mar 2020 03:17 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12384 |
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