A 50-g glucose challenge test: is there any diagnostic cut-off?

OBJECTIVE: To evaluate the diagnostic performance of 50-g glucose challenge test for diagnosis of gestational diabetes. MATERIAL AND METHOD: A retrospective study was conducted by reviewing the medical records of pregnant women who had a 50-g glucose challenge test of 140 mg/dL or higher and followed by a 100-g glucose tolerance test. Results were categorized in 10 mg/dL increments. Gestational diabetes was diagnosed using National Diabetes Data Group criteria. RESULTS: The present study included 2,226 cases from universal screening of 11,084 pregnant women. The incidence of gestational diabetes was 3.2% (351/11,084). Only 1.6% (6/374) of patients with positive screening results of less than 145 mg/dL had gestational diabetes. All of the 6 women undiagnosed by this threshold were gestational diabetes class A1 and had at least one risk factor Of 1,875 women, seven cases (0.4%) would be over diagnosed as gestational diabetes if 100-g glucose tolerance test was not performed after a result of 50-g glucose challenge test of > or = 250 mg/dL (99.6% specificity, 85.8% negative predictive value, 12.3% sensitivity and 86.0% positive predictive value). CONCLUSION: A 50-g glucose challenge test may be used as a diagnostic test when the value is > or = 250 mg/dL. The present data suggested that the value of glucose screening of > or = 145 mg/dL can be used as a threshold for a positive test in the low risk women.

Correlation of 4- and 24-hour urine protein in women with initially diagnosed hypertensive disorders in pregnancy.

OBJECTIVE: To determine whether 4-hour urine protein value correlates with 24-hour urine protein value in women with hypertensive disorders in pregnancy. STUDY DESIGN: Cross-sectional study was performed in 38 in-patient pregnant women who were initially diagnosed as having hypertensive disorders in pregnancy. Urine samples were collected within 24 hours in 2 successive periods: the first 4-hour and the next 20-hour urine, in separate containers. The urine volume, urine protein and creatinine concentrations were thus separately measured. The 4- and 24-hour urine proteins were calculated and the correlation between both groups was determined by simple linear regression analysis. RESULTS: A total of 38 patients were recruited into the study, 26 had mild preeclampsia, 5 had severe preeclampsia, and 7 had superimposed preeclampsia. The result of the 4-hour urine protein was found to correlate with those of the 24-hour urine protein for patients with hypertensive disorders in pregnancy (p < 0.001). CONCLUSION: Total protein values of 4-hour samples positively correlated with values of 24-hour samples of patients with hypertensive disorders in pregnancy. This might be modified and used for urine protein collection in outpatients to improve the compliance.

Correlation between random urinary protein-to-creatinine ratio and quantitation of 24-hour proteinuria in preeclampsia.

OBJECTIVE: To determine whether random urinary protein-to-creatinine ratio correlated with the quantitation of 24-hour proteinuria in cases of preeclampsia. DESIGN: Cross-sectional descriptive study. SUBJECTS: Pregnant patients hospitalized in the obstetric ward, King Chulalongkorn Memorial Hospital due to preeclampsia. METHOD: The random urine specimens were obtained from the eligible subjects for protein-to-creatinine ratio determination, the subjects were then instructed to collect 24-hour urine samples for protein measurement. RESULTS: Twenty-five pregnant patients completed the study. There was a strong correlation between the random urinary protein-to-creatinine ratio and the quantitation of 24-hour proteinuria (r = 0.929, p < 0.001). CONCLUSION: The presented data support a strong correlation between random urinary protein-to-creatinine ratio and quantitation of 24-hour proteinuria in hospitalized pregnant patients with preeclampsia.