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
The diagnosis of placental abruption is mostly clinical, histopathological diagnosis is poorly sensitive. Acute and chronic inflammatory processes had been proposed to cause placental abruption evidences that supports this remains sparse. To assess the correlation between the clinical diagnosis and histopathological findings of placental abruption and to examine the profile of chronic and acute histological lesions associated with clinical abruption. The study included fifty singleton pregnant women with a suspected clinical diagnosis of placental abruption compared to fifty consecutive normal pregnancies [control group], attending AL -Yarmouk Teaching Hospital over a period of twelve months, from the first of April 2010 to the end of march 2011. Examination of the concordance between clinical indicators for placental abruption with those of a histological diagnosis was done. The profile of acute and chronic lesions was also examined histopathologically. Among the fifty clinically diagnosed placental abruption cases, thirteen percent [fifteen patients] were confirmed as placental abruption based on gross and histological findings. The most common indication leading to a clinical diagnosis of abruption was evidence of retroplacental clot[s] or bleeding . Acute lesions that were associated with abruption with confirmed pathology included chorioamnionitis, and chorionic villous hemorrhage. Among the chronic lesions, chronic deciduitis, decidul vasculopathy, and dysmaturation were associated with pathologically confirmed placental abruption. The relation between clinical and histological diagnosis of placental abruption remains weak. Acute and chronic histological lesions were observed more frequently in placentas of pregnancies complicated by placental abruption than the control cases.