ABSTRACT
Background: Measurement of protein excretion in a 24-hour urine collection has been the long-standing gold-standard but time consuming test for the quantitative evaluation of proteinuria induced by preeclampsia. An alternative method is the measurement of protein- creatinine ratio in a spot urine sample, which provides a more convenient and rapid method to assess protein excretion
Objective: To assess the correlation between the spot urine protein- creatinine ratio and 24-hour urine protein excretion in women with preeclampsia and to use the urine protein- creatinine ratio as alternative to time-consuming 24-hour urine protein collection. Study design: A cross sectional study.Setting: Department of Obstetrics and Gynecology at Al-Yarmouk Teaching Hospital for a period of one year from Jan. 2013 to Jan. 2014
Patients and Methods: Eighty three singleton pregnant women suffering from pre-eclampsia with gestational age between 28 to 39 weeks were selected to participate in the study. They were divided into two groups: 61 pregnant women with mild to moderate pre-eclampsia and 22 with severe pre-eclampsia.These women were prospectively studied for proteinuria. Urine protein- creatinine ratio was determined in a spot mid-stream urine sample, and the amount of protein excretion was measured in 24-hour urine collected on the subsequent day. The correlation between the two tests was assessed
Results: Diagnostic value of protein/creatinine ratio was expressed in terms of specificity and sensitivity.There was significant correlation between protein/ creatinine ratio in a single void urine with 24 hr. urine collection for protein as the P value was [0.0001], The ROC curve analysis showed an area under the curve of [0.879], indicating that the urine protein: creatinine ratio can detect severe proteinuria at a cutoff point of 4.2 with a sensitivity of [81.8%] and specificity of [85.2%]
Conclusion: There is a significant correlation between the spot urine protein/ creatinine ratio and 24-hour urine protein excretion in women with preeclampsia
ABSTRACT
Prompt diagnosis of ectopic pregnancy is a difficult dilemma, and reliable predictors for diagnosis and differentiation of ectopic pregnancy from early pregnancy miscarriage are needed. To evaluate the diagnostic value of serum progesterone and CA-125 levels in ectopic pregnancy and early intra uterine miscarriage. A prospective case control study. The study was carried out in the department of obstetrics and gynecology of AL-Yarmouk teaching hospital [Baghdad - Iraq] from February 2011 to February 2012. This study was carried out on sixty pregnant women in their first trimester. Twenty women diagnosed as unruptured ectopic pregnancy; treated by laparotomy, twenty women diagnosed as inevitable miscarriage; treated by curettage and twenty women with healthy pregnancy of a comparable gestational age as control group; follow up of this group was done to ascertain uneventful pregnancy with no complications. We compared the serum levels of progesterone and CA-125 in all groups at the time of presentation and 24h after surgical intervention in first and second groups. There was a significant decrease in mean post operative progesterone level in women with ectopic pregnancy and miscarriage groups with significant difference [P<0.0001]. The study observed that the mean level of progesterone in women with ectopic group [6.76 +/- 3.63 ng/ml] was lower than that in miscarriage group [15.17 +/- 6.01 ng/ml] and control group [17.58 +/- 4.57 ng/ml] with significant difference [P<0.0001]. This study also observed that the mean level of CA-125 in women with miscarriage group [117.07 +/- 94.30 U/ml] was higher than that in ectopic group [38.11 +/- 28.79 U/ml] and control group [30.51 +/- 16.10 U/ml] with statistically significant difference [P<0.0001]. There was a significant decrease in mean level of post operative CA-125 in women with ectopic pregnancy and miscarriage groups with significant difference [P<0.0003]. Combined measurement of both serum progesterone and CA-125 can be sensitive predictors in diagnosis and differentiation of ectopic pregnancy from inevitable miscarriage and normal pregnancy