Rao Shraddha, Somalwar Savita, Bhalerao Anuja, Raman Vishal
Department of Obstetrics and Gynecology, NKP Salve Institute of Medical Sciences and Research Center, Nagpur, IND.
Cureus. 2023 Jun 5;15(6):e39961. doi: 10.7759/cureus.39961. eCollection 2023 Jun.
Background Among the hypertensive disorders of pregnancy, certain diseases like preeclampsia (PE) and eclampsia have the maximum impact on morbidity and mortality of the mother as well as the newborn. Proteinuria determination is used to assess renal damage in PE. There are several ways to evaluate proteinuria in pregnant women, but the gold standard remains the 24-hour urine albumin (24-h UA) excretion. Spot urine albumin creatinine ratio (UACR) can be used for rapid diagnosis of PE which is fast, reliable, and easy to use. Hence, our tertiary care center conducted the current study to assess the accuracy of spot UACR with 24-h UA for detecting proteinuria in antenatal women to diagnose PE and to evaluate the obstetric outcome in antenatal women with PE. Methodology A descriptive, cross-sectional study was conducted on 98 antenatal women diagnosed with PE. Urine albumin was done by dipstick method and the presence or absence of proteinuria was noted. Both, the 24-h urine sample and a random sample for spot UACR were sent for analysis. Results Spot UACR has more specificity than sensitivity along with a high negative predictive value for the detection of proteinuria. Additionally, significant proteinuria was associated with an increased rate of induced labor, a cesarean section in patients, lower mean gestational age at the time of delivery, lower birth weight, and increased rate of intrauterine fetal death. Conclusion The study concluded that spot UACR has more specificity than sensitivity along with a high negative predictive value for the detection of proteinuria and therefore, can be used for the diagnosis of proteinuria in women with PE. Hence, spot UACR is a reliable, faster, and more accurate method for the detection of proteinuria in PE and can be used for early diagnosis and timely management leading to a decrease in mortality and morbidity of the mother and the fetus.
背景 在妊娠高血压疾病中，某些疾病如子痫前期（PE）和子痫对母亲及新生儿的发病率和死亡率影响最大。蛋白尿测定用于评估子痫前期的肾损伤。评估孕妇蛋白尿有多种方法，但金标准仍是24小时尿白蛋白（24-h UA）排泄量。随机尿白蛋白肌酐比值（UACR）可用于子痫前期的快速诊断，其快速、可靠且易于使用。因此，我们的三级医疗中心开展了本研究，以评估随机UACR与24-h UA检测产前妇女蛋白尿以诊断子痫前期的准确性，并评估子痫前期产前妇女的产科结局。
方法 对98例诊断为子痫前期的产前妇女进行了一项描述性横断面研究。采用试纸法检测尿白蛋白，并记录有无蛋白尿。将24小时尿样本和随机尿样用于UACR检测并送检分析。
结果 随机UACR在检测蛋白尿方面特异性高于敏感性，且具有较高的阴性预测值。此外，显著蛋白尿与引产率增加、剖宫产率增加、分娩时平均孕周降低、出生体重降低及宫内胎儿死亡发生率增加相关。
结论 该研究得出结论，随机UACR在检测蛋白尿方面特异性高于敏感性，且具有较高的阴性预测值，因此可用于子痫前期妇女蛋白尿的诊断。因此，随机UACR是一种检测子痫前期蛋白尿可靠、快速且更准确的方法，可用于早期诊断和及时管理，从而降低母亲和胎儿的死亡率和发病率。
