Volume 11, Issue 8 (11-2013)                   IJRM 2013, 11(8): 647-0 | Back to browse issues page

XML Persian Abstract Print


1- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Rasht, Iran
2- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Rasht, Iran , royafaraji1371@yahoo.com
3- Department of Midwifery, Guilan University of Medical Sciences, Rasht, Iran
4- Department of Biostatistic, Guilan University of Medical Sciences, Rasht, Iran
5- Guilan University of Medical Sciences, Rasht, Iran
Abstract:   (2016 Views)
Background: Measuring the 24-hour urine protein ≥300 mg is the standard threshold value for diagnosis of preeclampsia.
Objective: This study was intended to determine if a patient’s 4-hour urine protein correlate with the 24-hour value for diagnosis of preeclampsia.
Materials and Methods: This was a cross sectional study performed on 84 women with suspected preeclampsia due to positive urinary test strip with minimum protein content of 1+ and BP ≥140/90 at Al-zahra Educational Hospital in Rasht (Iran) from May 2007 to January 2008. Urine samples were collected within 24 hours in successive periods: The first 4-hour and the next 20-hours urine, in separate containers. The protein contents of 4-hour and 24-hour urine samples were calculated. Data were analyzed by intra-class correlation coefficient, and Receiver Operating Characteristic (ROC) curve.
Results: The ROC curve showed the cut-off point of 55.5 for 4-hour urine protein. The correlation between 4- and 24-hour urine protein excretions identified that most women (about 85.1%) with protein excretion rate of 300 mg/24h or more (with preeclampsia) had the same amount of protein of 55.5 or more in their 4-hour urine excretion (p<0.001). Also, most of them (about 83.7%) with a total urinary protein excretion of less than 300 mg/24h (no preeclampsia) had a protein excretion rate of less than 55.5 mg/4h.
Conclusion: This study showed 4-hour protein collection can be used as acceptable substitute for assessing the protein content of 24-hour urine samples as a more convenient, faster, and cheaper method for diagnosis of preeclampsia and the cut-off point for 4-hour urine protein is 55.5 mg.
Full-Text [PDF 524 kb]   (642 Downloads) |   |   Full-Text (HTML)  (278 Views)  
Type of Study: Original Article |

References
1. Gabee SG, Niebyl JR, Simpson JL. Obstetrics: Normal and problem pregnancies. 4th Ed. USA, Churchill Livingstone; 2002: 945.
2. Scott JR, Gibbs RS, Karlan BY, Haney AF. Danforth's obstetrics and gynecology, 9th Ed. Philadelphia, Lippincott Williams & Wilkins; 2003: 333-354.
3. Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet 2005; 365: 785-799. [DOI:10.1016/S0140-6736(05)71003-5]
4. Lim K, Steinberg G. Preeclampsia. Available at: http: //Emedicine. medscape. com/ article/ 1476919- over view [accessed on 2009].
5. Cunningham FG, Leveno KJ, Bloom SL, et al. Williams Obstetrics. 23nd Ed. NewYork, Mcgraw-Hill; 2010: 761-775.
6. Goldenberg RL, Rouse DJ. Prevention of premature birth. N Engl J Med 1998; 339: 313-320. [DOI:10.1056/NEJM199807303390506]
7. Berg CJ, Chang J, Callaghan WM, Whitehead SJ. Pregnancy-related mortality in the United States, 1991-1997. Obstet Gynecol 2003; 101: 289-296.
8. Amirabi A, Golmohammadlu S, Yekta Z, Naji S, Danaii Sh. [Correlation of 4- hour urinary protein with 24-hour proteinuria in Hospitalized patient with hypertention disorder]. Urmia Med J 2010; 21: 10-16. (In Persian)
9. Somanathan N, Farrel T, Galimberti A. A comparison between 24-hour and 2-hour urine collection for thedetermination of proteinuria. J Obstet Gynecol 2003; 23: 378-380. [DOI:10.1080/0144361031000119538]
10. Aggarwal N, Suri V, Soni S, Chopra V, Kohli HS. A prospective comparison of random urine protein-creatinine ratio vs 24-hour urine protein in women with Preeclampsia. Medscape J Med 2008; 10: 98.
11. Ragip A, Bayalk C, Karacacy O, Geyik P, DolenI A. Random urine protein geratinine ratio to prdict proteinuria in new onset mild hypertention in late pregnancy. Obstet Gynecol 2004; 104: 367-370. [DOI:10.1097/01.AOG.0000134788.01016.2a]
12. Rodrigues-thompson DR, Liebeman E. Use of a random urinary protein to geratenine ratio for during pregnancy. Am J Obstet Gynecol 2001; 85: 808-811. [DOI:10.1067/mob.2001.117349]
13. Waugh JJ, Clark TJ, Divakaran TG, Khan KS, Kilby MD. Accuracy of urinalysis dipstick techniques in predicting significant proteinuria in pregnancy. Obstet Gynecol 2004; 103: 769-777. [DOI:10.1097/01.AOG.0000118311.18958.63]
14. Shahbazian N, Hosseini-Asl,l F. A comparison of spot urine protein-Creatinine Ratio with 24-hour urine protein excretion in women with preeclampsia. Iran J Kidney Dis 2008; 2: 127-131.
15. Raungkaewmanee S, Phaloprakarn C, Manusirivithaya S, Wiriyasirivaj B. A Two-hour Urinary Protein-creatinine Ratio for Predicting Significant Proteinuria in Preeclampsia. Thai J Obstet Gynaecol 2009; 17: 196-203.
16. Moslemizadeh N, Yousefnejad K, Moghadam TG, Peyvandi S. Urinary protein assessment in preeclampsia: which sampleis more suitable. Pak J Biol Sci 2008; 11: 2584-2588. [DOI:10.3923/pjbs.2008.2584.2588]
17. Douma CE, van der Post JA, van Acker BA, Boer K, Koopman MG. Circadian variation of urinary albumin excretion in pregnancy. Br J Obstet Gynaecol 1995; 102: 107-110. [DOI:10.1111/j.1471-0528.1995.tb09061.x]
18. Wongkitisophon K, Phupong V, Yamasmit W, Pansin P, Tannirandorn Y, Charoenvidhya D. Correlation of 4- and 24-hour urine protein in women with initially diagnosed hypertensive disorders in pregnancy. J Med Assoc Thai 2003; 86: 529-534.
19. ShahgheibiSh, Naghshbandi M, Shahsavari S, Khaledian A. Assessment of correlation of 4 hour and 24 hour urine protein in pregnant women with hypertensive disorders. Sci J Kurdistan Univ Med Sci 2007; 11: 1-5.
20. Wheeler TL 2nd, Blackhurst DW, Dellinger EH, Ramsey PS. Usage of spot urine protein to creatinine ratios in the evaluation of preeclampsia. Am J Obstet Gynecol 2007; 196: 1-4. [DOI:10.1016/j.ajog.2006.10.892]
21. Huang Q, Gao Y, Yu Y, Wang W, Wang S, Zhong M. Urinary spot albumin: creatinine ratio for documenting proteinuria in women with preeclampsia. Rev Obstet Gynecol 2012; 5: 9-15.
22. Saikul S, Wiriyasirivaj B, Charoenchinont P 1st. 4-Hour urinary protein-Cratinine Ratio for Diagnosis of significant proteinuria in preeclampsia. J Med Assoc Thai 2006; 89: 542-544.
23. Amirabi A, Danaii SH. A Comparison of 4- and 24-Hour Urine Samples for the Diagnosis of Proteinuria in Pregnancy. Iran J Med Sci 2011; 36: 167-171.
24. Rabiee S. Comparison of predictive value of 8, 12 and 24-hour proteinuria in pre-eclampsia. Pak J Med Sci 2007; 23: 182-184.
25. Tun C, Qui-ones JN, Kurt A, Smulian JC, Rochon M. Comparison of 12-hour urine protein and protein:creatinine ratio with 24-hour urine protein for the diagnosis of preeclampsia. Am J Obstet Gynecol 2012; 207: 233. [DOI:10.1016/j.ajog.2012.06.010]
26. Adelberg AM, Miller J, Doerzbacher M, Lambers DS. Correlation of quantitative protein measurements in 8-, 12-, and 24-hour urine samples for the diagnosis of preeclampsia. Am J Obstet Gynecol 2001; 185: 804-807. [DOI:10.1067/mob.2001.117302]

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.