First 4-Hour Urinary Protein - Creatinine Ratio for Diagnosis of Significant Proteinuria in Preeclampsia
Sornpin Saikul MD*, Budsaba Wiriyasirivaj MD*, Paiboon Charoenchinont MD*
Affiliation : * Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital
Objective : To evaluate the diagnostic accuracy of the first 4-hour urinary protein - creatinine ratio for
prediction of the significant proteinuria in preeclampsia
Study
Design : Diagnostic test
Subjects : One hundred and sixty-four pregnant women who were initially diagnosed with hypertensive disor-
der and hospitalized in the obstetric ward and labor room at Bangkok Metropolitan Administration Medical
Collage and Vajira Hospital between July 2005 and April 2006.
Materials and Methods : Urine samples were collected within 24 hours in two consecutive periods: the first 4
hours and the next 20 hours. The urine volume, urine protein and creatinine concentration were separately
measured and the first 4-hour urinary protein - creatinine ratio were calculated. With the use of a protein level
> 300 mg in 24 hours urine collection as the gold standard, the sensitivity and specificity of the first 4-hour
urinary protein-creatinine ratio for diagnosis of significant proteinuria were determined with cutoffs range.
Results : One hundred and sixty four patients were recruited for this study including 112 patients (68.3%) who
had preeclampsia. The first 4-hour urinary protein-creatinine ratio was most accurate for diagnosis of preec-
lampsia is 0.30 with 81% sensitivity, 88% specificity, PPV of 93%, and NPV of 71%.
Conclusion : The first 4-hour urinary protein-creatinine ratio at 0.3 is the most accurate value for diagnosis of
significant proteinuria in preeclampsia
Keywords : First 4-Hour urinary protein-creatinine ratio, Significant proteinuria, Preeclampsia
