Quantitation of Proteinuria in Women With Pregnancy Induced Hypertension: Is it Time to Abandon Use of Dipstick Strips for the Spot Urine Protein to Creatinine Ratio?
AbstractContext: The presence of significant proteinuria in Pregnancy Induced Hypertension is associated with worse maternal and fetal outcome. Unfortunately, Dipstick strips, currently used widely for detection and quantitation of proteinuria, have been shown to be unreliable. This creates the need for a more accurate method for early detection and quantitation of proteinuria.
Objective:To compare the accuracy of the Spot urine Protein to Creatinine ratio with that of Dipstick Tests in the quantitation of proteinuria in Nigerian women with Pregnancy Induced Hypertension.
Methods: A cross-sectional survey over a 6-month period involving 86 Nigerian women with Pregnancy Induced Hypertension.
Outcome measures: False Positive rates, False Negative rates, Sensitivity, Specificity, Positive Predictive value, Negative Predictive value, and Accuracy.
Result: The Spot urine Protein to Creatinine ratio showed better correlation with 24-hour urine protein measurement than Dipstick Tests. Comparatively, the False positive rates were 16.2% versus 53.7%, False Negative rates 6.1% versus 28.1%, Sensitivity 91.2% versus 73.5%, Specificity 88.5% versus 44.4%, Negative predictive values 93.9% versus 71.9%, and Accuracy 89.5% versus 55.8% respectively for the Spot urine Protein to Creatinine ratio and Dipstick Tests.
Conclusion: The Spot Urine Protein to Creatinine ratio is much more accurate in the quantitation of proteinuria in Nigerian women with Pregnancy Induced Hypertension than the widely used Dipstick Tests.
Key Words: Quantitation, Proteinuria, Pregnancy, Hypertension.
[Trop J Obstet Gynaecol, 2004;21:136, 137, 140, 141]
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