European Journal of Molecular & Clinical Medicine

Abstract

Background:The aim is to compare the spot urine protein/creatinine ratio with 24hour
urinary protein in hypertensive disorders of pregnancy.
Materials and Methods: A prospective correlational study was conducted on 100
hypertensive pregnantwomen during the study period. The objective of the study was to
know if a spot protein/creatinine ratio would provide an accurate quantification of
proteinuria and whether it can replace the use of the 24 hours urine protein in
preeclamptic women. Ethical clearance and informed consent were obtained. Urine
samples were collected for visual dipstick, spot urine P/C ratio and 24hours urinary
protein estimation.
Results: A fair degree of correlation existed between the two variables with r =
0.842with a highly significant p value <0.01 when all the observations were considered.
The correlation at lower level of proteinuria was less r = 0.72 compared to higher levels
of proteinuria,but is statistically significant. The area under the ROC curve - 0.739
(95% CI: 0.628, 0.849) with p value < 0.01 (significant). The optimal cut off point was
0.5, which yielded a sensitivity of 92% and specificity - 66%. Even though the results
were known to clinicians the values were not taken for clinical decision, only by the
ratio alone. However the 24 hour urine protein values were considered for the patient
management. The perinatal outcome in women with higher levels of proteinuria were
poor with increased incidences of IUGR, prematurity, low birth weight and the need for
NICU care was increased in such babies.
Conclusion: The present study indicates that this method for quantification of
proteinuria, when properly interpreted, can provide valuable information, that for
clinical purposes is a satisfactory substitute for the determination of protein excretion in
a 24 hour collection.