Comparison of Spot Urine Protein-Creatinine Ratio With 24-Hour Urine Protein in Women with Preeclampsia

Abstract

Abstract

Objective: To determine the diagnostic accuracy of spot protein creatinine ratio (sPCR) in predicting preeclampsia, taking 24 hours urinary protein as the gold standard.

Methodology: This descriptive analytical study was carried out at the Department of Obstetrics and Gynecology, Pakistan Institute of Medical Sciences, Islamabad from May 2021 to November 2021. The inclusion criteria were pregnant women with suspected preeclampsia, who were aged 20-40 years with singleton pregnancy and a gestational age >20 weeks. Patients having fulminant preeclampsia and those with associated comorbid conditions such as urinary tract infection, gestational diabetes mellitus, chronic hypertension, chronic liver disease and renal disease were excluded. All included women provided a 24-hour urine collection for determination of proteinuria. All women were advised to pass urine at 6:00 am and collect all the urine subsequently till 6:00 am the next morning (24-hour period). The adequacy of urine collection was determined by creatinine excretion. Urine sample for spot protein-creatinine ratio was collected the next morning after the 24-hour collection was over. Urinary protein quantitation was done by Biuret method, and urinary creatinine estimation was done by modified Jaffe's method.

Results: Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of protein creatinine ratio in predicting pre-eclampsia, taking 24 hours urinary protein as gold standard was 86.96%, 87.36%, 84.51%, 89.41% and 87.18% respectively.

Conclusion: The diagnostic accuracy of spot urine protein creatinine ratio in predicting preeclampsia was reasonably high. Hence we recommend it as the preliminary screening modality for diagnosing preeclampsia in our pregnant population. It is beneficial on the accounts of its being of economical, simple and fast.

Keywords: Preeclampsia, Spot protein creatinine ratio, 24 hours urine. Pregnancy.