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      Calcium-to-Creatinine Ratio in a Spot Sample of Urine, for Early Prediction of Hypertensive Disorders of Pregnancy: A Prospective Study

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          Abstract

          Background

          Hypertensive disorders complicate 5–10 % of all pregnancies. Various methods for screening have been studied to identify pregnant women at risk of development of preeclampsia, but no ideal screening test has been identified so far. The objective of this study was to determine the efficacy of urinary calcium-to-creatinine ratio, in a spot urine sample, for the prediction of preeclampsia in asymptomatic pregnant women between 18 and 24 weeks of gestation.

          Methods

          This study was done on 112 patients presenting to the antenatal clinic in the Department of Obstetrics and Gynecology at Bangalore Baptist Hospital. A random urinary calcium-to-creatinine ratio of all the patients was analyzed. The urinary calcium level was analyzed by Arezano method, while creatinine was estimated by Jaffes method. A value of ≤0.04 was considered positive.

          Results

          116 patients were recruited in the study. Out of the 11 subjects with urinary CCR < 0.04, 7 developed gestational hypertension, 3 developed preeclampsia, and 1 remained normotensive. In 101 patients with CCR > 0.04, 1 developed gestational hypertension, none preeclampsia and 100 were normotensive. Four were lost to follow-up.

          Interpretation and Conclusion

          On statistical analysis, it was found that when CCR alone is taken as high-risk factor for prediction of preeclampsia, P < 0.001 was statistically significant, sensitivity was 80 %, specificity 98.04 %, PPV 80 %, NPV 98.04 %, and diagnostic accuracy 96.43 %. So this test was satisfactory as an early predictor for the development of preeclampsia.

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          Author and article information

          Contributors
          anitawd@gmail.com
          080 2202 4700
          Journal
          J Obstet Gynaecol India
          J Obstet Gynaecol India
          Journal of Obstetrics and Gynaecology of India
          Springer India (New Delhi )
          0971-9202
          0975-6434
          19 November 2015
          October 2016
          : 66
          : Suppl 1
          : 94-97
          Affiliations
          [1 ]Department of Obstetrics and Gynecology, Bangalore Baptist Hospital, Bellary Road, Hebbal, Bangalore, Karnataka 560024 India
          [2 ]7 Stephens Road Cross, Frazer Town, Bangalore, 560005 India
          Article
          PMC5016423 PMC5016423 5016423 797
          10.1007/s13224-015-0797-3
          5016423
          27651585
          © Federation of Obstetric & Gynecological Societies of India 2015
          Categories
          Original Article
          Custom metadata
          © Federation of Obstetric & Gynecological Societies of India 2016

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