Reappraisal of the relationship between 24-hour proteinuria and preeclampsia in terms of the maternal and perinatal outcomes (original) (raw)
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Proteinuria in preeclampsia: is it important?
Ginekologia polska, 2018
Our aim is to evaluate the laboratory results and proteinuria levels of preeclamptic women and their relation-ships to maternal and fetal outcomes. One hundred preeclamptic pregnant women who gave birth in our clinic between 2013 and 2015 were included in our study retrospectively. The data collected from the patients included gestational week, age, gravidity, parity, abortus history, blood pressure, biochemical parameters, delivery method, maternal hospitalization time, cesarean indication, complications, blood products required, plasmapheresis use and dialysis need. The details about the newborns were recorded retrospectively. The relationships between preeclampsia signs and maternal and neonatal out-comes were analyzed. The protein amounts were analyzed via 24-hour collected urine analyses and spot urine analyses. A statistically significant positive correlation was observed between neonatal intensive care unit needs and pro-teinuria levels. Fetal growth restriction, respiratory ...
2017
Results: The mean resolution time of proteinuria was 3 days; 3.5 days in the SPE group and 2.1 days in the NSPE group (p=0.002). The resolution time of proteinuria had a good predictive value for poor maternal outcome with an ROC-AUC of 0.73 (95% CI 0.59–0.88; p=0.002), the sensitivity and specificity were 62.5% and 80.2%, respectively. Proteinuria lasted longer than 3 days related with a higher risk of poor maternal outcomes. The ROCAUC value of the resolution time of proteinuria for severe preeclampsia was found to be 0.70 (95% CI 0.61–0.80; p = 0.001). The sensitivity and specificity were 72.1% and 63.5%, respectively. Amount of proteinuria at diagnosis had a statistically significant relationship with the presence of proteinuria at discharge (OR 2.70; 97.5% CI 1.32–6.02; p = 0.0096).
Role of proteinuria in defining pre-eclampsia: Clinical outcomes for women and babies
Clinical and Experimental Pharmacology and Physiology, 2010
1. The presence of proteinuria is not essential to the diagnosis of pre-eclampsia under many diagnostic consensus statements. The aim of the present study was to assess maternal and perinatal outcomes after proteinuric pre-eclampsia compared with other non-proteinuric disease presentations.
Severe proteinuria as a parameter of worse perinatal/neonatal outcomes in women with preeclampsia
Pregnancy Hypertension, 2020
The present study aimed to determine the relationship between the severity of proteinuria and maternal/neonatal outcomes among women with preeclampsia. Study design: Proteinuria severity was measured at preeclampsia diagnosis and at delivery in 94 women with preeclampsia (among 2904 women with singleton pregnancies, who delivered after 22 gestational weeks). Preeclampsia was defined as hypertension with proteinuria. Main outcome measures: Protein:creatinine (P/C) ratio to worse the maternal outcome was 4.8 among women with preeclampsia. Results: The frequencies of HELLP syndrome and maternal pulmonary edema in women with a P/C ratio ≥5.0 (35.5% and 35.5%, respectively) were significantly higher than those in women with a P/C ratio < 5.0 (12.7%, P = 0.014 and 6.4%, P < 0.001, respectively). The best P/C ratio cutoff value to determine early-onset preeclampsia and early preterm birth (EPB) was 4.1 (P < 0.001 and P < 0.001, respectively). The best P/C ratio cutoff values to determine the interval between the preeclampsia diagnosis and delivery < 7 days and the need to undergo cesarean section were 1.8 and 1.5, respectively. The best P/C ratio cutoff value to determine maternal pulmonary edema and central serous chorioretinopathy (CSC) was 4.8 (P = 0.020 and P = 0.014, respectively). Finally, the best P/C ratio cutoff values to determine EPB and maternal CSC in women with preeclampsia were 4.1 (odds ratio, 10.9; 95% confidence interval; 4.08 to 29.2, P < 0.0001) and 4.8 (odds ratio, 17.6; 95% confidence interval; 0.898 to 344, P = 0.0008), respectively, according to the multivariate analysis. Conclusions: A higher P/C ratio at delivery in women with preeclampsia might cause EPB and CSC. However, in 2013, the ACOG removed the severity criteria of proteinuria from the diagnostic criteria for preeclampsia [7]. Thus, in 2015, the Japan Society for the Study of Hypertension in Pregnancy recommended that the termination of pregnancy among women with conservatively managed preeclampsia is not necessary merely because they have severe proteinuria. In 2018, the International Society for the Study of Hypertension in Pregnancy (ISSHP) defined presence of proteinuria is not necessary to diagnose preeclampsia [8]. In the current Japanese criteria for "Hypertension disorders in pregnancy" since 2018, preeclampsia was defined as onset hypertension since 20 GW with one or more other maternal complication(s) following proteinuria, including liver dysfunction without underlying liver diseases, perinatal
Isolated gestational proteinuria preceding the diagnosis of preeclampsia - an observational study
Acta Obstetricia et Gynecologica Scandinavica, 2016
Introduction: Some pregnant women develop significant proteinuria in the absence of hypertension. However, clinical significance of isolated gestational proteinuria (IGP) is not well understood. This study aimed to determine the prevalence of IGP in singleton pregnancies and the proportion of women with IGP who subsequently developed preeclampsia (IGP-PE) among all PE cases.
Journal of Research in Medical Sciences, 2006
Background: The purpose of this study was to evaluate whether a random urinary protein / creatinine ratio is a clinically useful predictor of significant proteinuria (≥300 mg/24 hr) instead of 24- hours urine protein, among women with suspected preeclampsia. Methods: Women with suspected preeclampsia and gestational age of ≥20 weeks were included in a prospective study. Patients with chronic hypertension, diabetes mellitus, or preexisting renal disease were excluded. Protein/creatinine ratio was obtained before 24-hours urine collection. Positive and negative predictive values and sensitivity and specificity of the protein/creatinine ratio for significant proteinuria (≥ 300 mg) were calculated, based on 24hours urine total protein. Results: 100 women were evaluated totally. Mean maternal and gestational ages were 27.3 years and 33.26 weeks, respectively.73% of cases had significant proteinuria based on 24-hours urine collection. Good correlations were found between the protein/creat...
Journal of Nepal Medical Association, 2024
Introduction: Proteinuria is usually related with preeclampsia during pregnancy, although it can also be caused by other conditions such as renal disease or isolated proteinuria. Proteinuria during pregnancy can result in adverse fetomaternal outcomes. The study aimed to find the prevalence of proteinuria among pregnant women admitted to the Department of Obstetrics and Gynaecology of a tertiary care centre. Methods: A descriptive cross-sectional study was carried out among pregnant women in the Department of Obstetrics and Gynaecology after obtaining ethical approval from the Institutional Review Committee. Data of 14 April 2022 to 13 April 2023 was collected from 9 June 2023 to 9 September 2023 from medical records. The study included pregnant women aged 18-45 years, who were past 28 weeks of gestation and had a 24-hour urine protein measurement. Pregnant women who had insufficient medical records were excluded from the study. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 3,914 pregnant women, proteinuria was seen in 61 (1.56%) (1.17-1.95, 95% Confidence Interval). The mean proteinuria in the study group was 1.5±2.75 gm/24 hr. In pregnant women with proteinuria, maternal complications were seen in 51 (83.60%) and foetal complications in 34 (55.73%) cases. A total of 47 (77.05%) underwent emergency lower-section caesarean section. Conclusions: The prevalence of proteinuria among pregnant women was found to be similar as compared to studies done in similar settings.
Protein with 24 Hour Urinary Protein in Preeclampsia
2013
Objective: To find shortest and reliable time period of urine collection for determination of proteinuria. Materials and methods: It is a prospective study carried out on 125 pregnant women with preeclampsia after 20 weeks of gestation having urine albumin>1 using dipstick test. Urine was collected in five different time intervals in colors labeled containers with the assistance of nursing staff; the total collection time was 24 hours. Total urine protein of two-hour, four-hour, eight-hour, 12-hour and 24-hour urine was measured and compared with 24-hour collection. Data was analyzed using the Pearson correlation coefficient. Results: There was significant correlation (p value < 0.01) in two, four, eight and 12-hour urine protein with 24-urine protein, with correlation coefficient of 0.97, 0.97, 0.96 and 0.97, respectively. When a cut off value of 25 mg, 50 mg. 100 mg, and 150 mg for urine protein were used for 2-hour, 4-hours, 8-hour and 12-hour urine collection, a sensitivit...
Cureus, 2022
Background and objective Preeclampsia is a major contributor to morbidity and mortality among pregnant women and leads to poor fetomaternal outcomes. Predicting fetal and maternal health outcomes will enable early interventions so as to reduce further damage. Various biochemical tests like beta-human chorionic gonadotropin (β-HCG), inhibin A, activin A, pregnancy-associated plasma protein-A (PAPP-A), fetal DNA, and color Doppler have been studied for their ability to predict fetal and maternal health outcomes; however, most of these tests are complex and costly. Among the many variables that indicate the severity of outcomes in hypertensive disorders of pregnancy, the urinary protein-to-creatinine ratio (UPCR) is an important index. The aim of the study was to find out the association between UPCR and fetomaternal outcomes in preeclampsia. Material and methods A prospective observational study was conducted among 141 women with preeclampsia presenting with proteinuria, who were divided into two groups: 11% with UPCR <0.3 and 89% with UPCR ≥0.3. These patients were followed up till delivery to look for maternal and fetal outcomes.