Diagnostic Accuracy of Spot Protein/Creatinine ratio in Diagnosing Preeclampsia in Pakistani Women Keeping 24 hours Urine Protein as Gold Standard

Abstract

Objective: To assess the diagnostic accuracy of spot protein/creatinine ratio in diagnosing preeclampsia in Pakistani women keeping 24 hours urine protein as gold standard.

Methodology: This cross-sectional validation study was done at Pakistan Ordinance Factory Hospital, Wah Cantt from February 2022 to July 2022. A total of 340 pregnant women with new onset of hypertension, B.P ≥ 140/90 mmHg at two different occasions 6 hours apart were selected. Mid-stream urine sample on the day of admission was send for protein/creatinine ratio and next 24 hours urine sample was collected for 24 hours urinary protein excretion. Selectra-E biuret colorimetric assay was used to measure the total urinary protein and modified Jaffe test was used to measure the urine creatinine.

Results: The women average age was 27.54±3.84 years. The gestational average age was 23.32±2.8 weeks, and the average BMI was 25.38±3.38 Kg/m2. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of spot protein/creatinine ratio in diagnosing preeclampsia were 91.4%, 95.7%, 71.1%, 95.7% and 95.3% respectively.

Conclusion: In conclusion, the ratio of urinary protein/creatinine is a good predictor of proteinuria in preeclampsia and it can replace 24 hours urinary collection as a diagnostic test.