The New Indian Journal of OBGYN 4(2):117-120

Screening for preeclampsia by urine albumin to creatinine ratio

Anupma Upadhyay, Meena Dayal

ABSTRACT

Background: Proteinuria is a major component of preeclampsia. Urine protein measurement after 24 hour urine collection is the traditional standard method for the detection of proteinuria. It is time consuming. As an alternative, random spot sampling for a urine protein to creatinine ratio has been investigated. Objective: Screening for preeclampsia by urine albumin to creatinine ratio. Methods: The study was conducted on 202 antenatal women with gestational age 16-18 weeks. Specimens for measuring protein to creatinine ratio are obtained. Urine albumin was estimated by Bromocresol green assay and urine creatinine level was estimated by modified Jaff’s reaction. Urinary albumin to creatinine ratio of 0.2 or more was considered to be abnormal. Results: Out of 202 women 30 women had urine albumin creatinine ratio > 0.2 and 12 (40%) developed preeclampsia while out of 160 women with urine albumin to creatinine ratio <0.2 only 4 (2.5%) developed preeclampsia. The sensitivity, specificity, positive predictive value and negative predictive value of the test were 75%, 89.6%, 40% and 97.5% respectively. Conclusion: Spot urinary albumin to creatinine ratio is a reasonable rule out test for significant proteinuria. The Albumin to creatinine ratio is highly predictive to detect proteinuria and can be used as a rapid alternative test.