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Evaluation of Spot Urinary Albumin–Creatinine Ratio as Screening Tool in Prediction of Pre-eclampsia in Early Pregnancy

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Abstract

Objective

The aim of this study was to establish whether a spot urinary albumin/creatinine ratio (ACR) measured between 20 and 28 weeks of gestation can predict subsequent pre-eclampsia in asymptomatic pregnant women.

Design

Prospective observational study.

Subjects

The patients included sixty-two women with singleton pregnancy, normal renal function and no evident proteinuria, attending antenatal clinics between 20 and 28 weeks of gestation in a tertiary care hospital.

Methods

The ACR was determined from midstream urine sample taken between 20 and 28 weeks of gestation. Estimation of albumin was done by immunoturbidimetric microalbumin method and creatinine by modified Jaffe’s method.

Results

Incidence of pre-eclampsia in the study group was 12.90%. The cut-off value for ACR was taken as 35.5 mg/mol. The mean ACR in normotensive group was 19.26 ± 7.99, and in pre-eclampsia group it was 51.95 ± 18.78. For pre-eclampsia, screening in early pregnancy, spot ACR cut-off ≥35.5 mg/mol has sensitivity of 87.5%, specificity of 96.30%, PPV of 77.78% and NPV of 98.11%.

Conclusions

Spot urinary ACR values are higher in asymptomatic women in early pregnancy, who developed pre-eclampsia later on. When measured early in the second trimester, an ACR ≥ 35.5 mg/mmol predicted pre-eclampsia well before the onset of clinical manifestations with high sensitivity and specificity. It can be used as a good screening tool for predicting pre-eclampsia in early pregnancy.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, The Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, India

    Vineet V. Mishra, Preeti A. Goyal, Roy Priyankur, S. Choudhary, Rohina S. Aggarwal, Khushali Gandhi, Bhumika Vyas & Shaheen Hokabaj

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  1. Vineet V. Mishra
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  2. Preeti A. Goyal
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  3. Roy Priyankur
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  4. S. Choudhary
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  5. Rohina S. Aggarwal
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  6. Khushali Gandhi
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  7. Bhumika Vyas
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  8. Shaheen Hokabaj
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Corresponding author

Correspondence to Vineet V. Mishra.

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Conflict of interest

Vineet Mishra, Preeti Goyal, Priyankur Roy, Sumesh Choudhary, Rohina Aggarwal, Khushali Gandhi, Bhumika Vyas and Shaheen Hokabaj declare that they have no conflicts of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.

Additional information

Vineet V. Mishra, M.D., Ph.D., is Professor and HOD in Department of Obstetrics and Gynaecology, the Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences; Preeti A. Goyal, M.D., is Senior Resident in Department of Obstetrics and Gynaecology, the Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences; Roy Priyankur, M.S., is Clinical Fellow in Department of Obstetrics and Gynaecology, the Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences; S. Choudhary, M.D., DNB, is Assistant Professor in Department of Obstetrics and Gynaecology, the Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences; Rohina S. Aggarwal, M.D., is Professor in Department of Obstetrics and Gynaecology, the Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences; Khushali Gandhi, M.S., is Assistant Professor in Department of Obstetrics and Gynaecology, the Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences; Bhumika Vyas, DGO, is Senior Resident in Department of Obstetrics and Gynaecology, the Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences; and Shaheen Hokabaj, DNB, is Clinical Fellow in Department of Obstetrics and Gynaecology, the Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences.

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Mishra, V.V., Goyal, P.A., Priyankur, R. et al. Evaluation of Spot Urinary Albumin–Creatinine Ratio as Screening Tool in Prediction of Pre-eclampsia in Early Pregnancy. J Obstet Gynecol India 67, 405–408 (2017). https://doi.org/10.1007/s13224-016-0950-7

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  • DOI: https://doi.org/10.1007/s13224-016-0950-7

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