Latha Akkenapally Prasanna, Haripriya V, Ramya Raj P
Kamineni Academy of Medical Sciences and Research Centre (KAMSRC), LB Nagar, Hyderabad, Telangana India.
J Obstet Gynaecol India. 2023 Dec;73(Suppl 2):234-239. doi: 10.1007/s13224-023-01862-9. Epub 2023 Oct 31.
To determine utilization of spot urinary albumin/creatinine ratio (UACR) to predict subsequent development of preeclampsia, measured between 17 and 24 weeks of gestational age in asymptomatic antenatal woman and determine their maternal and neonatal outcomes.
In preeclampsia the basic pathology is generalized endothelial dysfunction. It causes glomerular endotheliosis which leads to proteinuria, decreased glomerular filtration rate and renal blood flow. Thus microalbuminuria is an early marker which can measured to predict preeclampsia.
It is a prospective observational study, carried out for one year in a cohort of asymptomatic antenatal women at 17-24 weeks of gestational age, attending hospital for routine antenatal check-up with a singleton pregnancy and no associated complications. Urine albumin and creatinine ratio (UACR) is measured at first visit, and women were followed till delivery and the maternal and foetal outcomes were recorded.
Out of 81 pregnant women enrolled in the study, 58% belonged to 18-25 years, 54.3% belonged to lower middle class. There was a significant difference in mean UACR among women who developed preeclampsia (PE) and gestational diabetes mellitus (GDM) with value < 0.05. In the study there was significant association between severe PE, PE and GDM with UACR at 22 as cut-off, with value < 0.05. In the study among those with UACR > 22, 2.5% had IUFD, 12.5% had LBW, and 7.5% were admitted to NICU.
With the measurement of spot UACR in mid-trimester we can predict the development of preeclampsia before the onset of clinical manifestations. UACR > = 171 mg/g predicted preeclampsia well before the onset of clinical manifestations with high sensitivity of 83.3% and specificity of 98.6%.
The online version contains supplementary material available at 10.1007/s13224-023-01862-9.
确定在无症状产前妇女孕17至24周时测量的随机尿白蛋白/肌酐比值（UACR）用于预测先兆子痫后续发生情况，并确定其母婴结局。
先兆子痫的基本病理是全身性内皮功能障碍。它会导致肾小球内皮病变，进而引起蛋白尿、肾小球滤过率降低和肾血流量减少。因此，微量白蛋白尿是可用于预测先兆子痫的早期标志物。
这是一项前瞻性观察性研究，在一组孕17 - 24周的无症状产前妇女中进行了一年，这些妇女因单胎妊娠且无相关并发症到医院进行常规产前检查。首次就诊时测量尿白蛋白和肌酐比值（UACR），对这些妇女进行随访直至分娩，并记录母婴结局。
在纳入研究的81名孕妇中，58%年龄在18 - 25岁，54.3%属于中下层阶级。发生先兆子痫（PE）和妊娠期糖尿病（GDM）的妇女之间的平均UACR存在显著差异，P值<0.05。在该研究中，以22为临界值时，重度PE、PE和GDM与UACR之间存在显著关联，P值<0.05。在该研究中，UACR>22的人群中，2.5%发生胎死宫内，12.5%为低出生体重儿，7.5%入住新生儿重症监护病房。
通过在孕中期测量随机UACR，我们可以在临床表现出现之前预测先兆子痫的发生。UACR >= 171 mg/g在临床表现出现之前能很好地预测先兆子痫，敏感性高达83.3%，特异性为98.6%。
在线版本包含可在10.1007/s13224 - 023 - 01862 - 9获取的补充材料。
