To Study the Diagnostic Accuracy of Spot Urinary Protein-Creatinine Ratio for Proteinuria in Pregnancy Induced Hypertension

Aim: To evaluate the diagnostic accuracy of spot urinary protein-creatinine ratio in single voided urine sample for quantification of proteinuria by comparing it with 24-hour urinary protein in patients with pregnancy induced hypertension. Material and Methods: 150 cases of Pregnancy Induced Hypertension admitted in ward/Labour room of Deptt of Obstt and Gynae, SRMSIMS were studied and grouped into mild and severe pre-eclampsia depending upon blood pressure, clinical and biochemical parameters. Midstream urine sample estimation for protein-creatinine ratio and 24-hr urine collection was done. Urine protein estimation was done by Pyrogollol red method and creatinine estimation was done by Jafee?s method. The derangements in fundoscopy, liver function and renal function tests with increasing grades of proteinuria and effects of Pre-eclampsia on maternal and fetal outcomes were also studied. Results: There is a strong correlation between the spot urinary protein-creatinine ratio with severity of pre-eclampsia. Severity of organ dysfunction is significantly related to Protein-creatinine ratio greater than 0.3. Conclusion: 24-hr urine protein is considered as gold standard; however collection is cumbersome, time consuming. Spot urine protein-creatinine is an accurate, reliable, and time saving which can be used as an alternative method for evaluation of proteinuria in Pre-eclampsia and it can substitute 24-hr urine protein estimation in clinical practice. The optimal spot protein-creatinine ratio cut off point was 0.3. This protein-creatinine ratio can be used in predicting disease severity in form of organ involvement, maternal and perinatal outcome. Clinical Significance: Determination of protein-creatinine ratio is a valuable tool to determine the severity of disease and adverse maternal and perinatal outcome.