Sindhu, D (2014) To Asses the predictive value of calcium to creatinine ratio in spot urine sample for early prediction of pre eclampsia. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.
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Abstract
INTRODUCTION: Hypertensive disorders during pregnancy constitute the most common medical disorders encountered by obstetricians. The incidence is 7% to 10 %, of which pre eclampsia and eclampsia constitute 70% and chronic hypertension 30%. It remains the leading cause for maternal mortality and morbidity worldwide accounting for 15 % to 20%. Pre eclampsia/eclampsia is a multi organ disorder unique to human pregnancy. The typical renal lesionsis glomeruloendotheliosis, which is the swelling of the glomerular capillary endothelial and mesangial cells. Involvement of renal system is well before the symptomatology of pre elampsia manifest. Pritchard stated that the presence of chorionic villi in women with pre eclampsia causes vasospasm leading to development of hypertension and serious multiorgan dysfunction, specifically confined to placenta, kidneys, liver and sometimes brain. As per many studies, presence of placenta is sufficient for development of pre eclampsia, there is no necessity of fetus, as pre eclampsia is seen is complete mole, there is no necessity of uterus as it can be seen in abdominal pregnancy also. So the pathogenesis of pre eclampsia will start as early as the trophoblastic invasion, so any insult at that time can lead to development of hypertension during pregnancy. AIM OF THE STUDY: To Asses the predictive value of calcium creatinine ratio in spot urine sample for early prediction of pre eclampsia. OBJECTIVES: 1. To asses predictive value of calcium creatinine ratio. 2. To asses maternal outcome. 3. To assess the mode of delivery. 4. To assess the fetal outcome. MATERIALS AND METHODS: The study was conducted in the dept of OBG, PSG Hospitals, and Coimbatore from July 2012 to May 2013. STUDY DESIGN: Prospective study. STUDY POPULATION: The study group consisted of 200 samples, randomly selected from the pateints attending the antenatal clinic from gestational age 24 weeks to 34 weeks. INCLUSION CRITERIA: 1. Singleton pregnancy. 2. Gestational age 24 to 34weeks. 3. Multipara with no history of hypertension. EXCLUSION CRITERIA: 1. Chronic hypertension. 2. Renal disease. 3. Multiple Pregnancy. 4. Autoimmune diseases. 5. Diabetes complicating pregnancy. 6. Previous abruption. 7. Previous IUGR. 8. Previous history of PIH. STATISTICAL ANALYSIS: Data collected were entered in Excel Spread sheet and analyzed using STATA statistical software package release 11. We used the two-sided independent-samples t test to compare means across dichotomous variables; the one-way ANOVA test for comparison of means across multilevel variables. Simple calculations like Percentages, Proportions and Mean values were derived. A type I error of 0.05 was considered in all analyses. Using ROC - AUC, the sensitivity, specificity, positive and negative predictive value of the test is calculated. CONCLUSION: A single estimation of CCR at less than or equal to 0.04 +_0.04, in a spot urine sample, in asymptomatic pregnant women between 24-34 weeks of pregnancy, may be used as a early forecaster of pre eclampsia future development of preeclampsia in asymptomatic low risk women, but with high negative predictive value it can be used as screening tool for pre eclampsia in high risk group. More randomized trials with the bigger sample size is needed for confirmation.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | predictive value ; calcium ; creatinine ratio ; spot urine sample ; early prediction ; pre eclampsia. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 25 Nov 2017 02:12 |
| Last Modified: | 24 Jun 2018 12:51 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4022 |
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