Calcium Creatinine Ratio in Prediction of Preeclampsia
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 5
Abstract
Background- There is hypercalciuria during a normal pregnancy , while PIH is associated with hypocalciuria and low urinary calcium-creatinine ratio. Since PIH represents a state of profound pathophysiological changes and, one of the important alteration is a change in urinary calcium creatinine ratio and microalbuminuria in patients of PIH , this test has emerged significantly as the early predictor for the development of PIH.Material and Methods- The present study was carried on in Department of Obstetrics and Gynaecology, Patna medical college and hospital over a period of two years from November 2012 to September 2014.This study was done on 100 normotensive patients with gestational age of 20- 24 weeks attending routine antenatal clinic. The patients were divided in two groups:- Study group – comprised of 50 normotensive patients who had either one or more risk factor for development of preeclampsia and Control group- comprised of 50 normotensive pregnant patients, who had no risk factors for development of preeclampsia. Urinary calcium is calculated from spot morning urine sample by Orthocresolpthalin method. Normal urinary excretion of calcium in healthy adult is 100 – 300 mg/day. Urinary creatinine is calculated by Jaffe’s method. Normal urinary creatinine excretion in healthy adult is 1.5 – 3 gram/day. All collected data was reviewed and analyzed for relationship of urinary calcium creatinine ratio with development of preeclampsia in both study and control group.Result-. Maximum number of patients in the study group and in the control group belonged to 18 – 25 years of age group. 70% were primigravidae. Less urinary calcium levels seen in cases of preeclampsia. Parity does not have any significant effect over calcium excretion in both groups of patients. In the study group (n = 50), 10 (20%) had CCR ≤ 0.04 while in the control group ( n = 50 ), 5 (10%) had CCR ≤ 0.04. Out of total 100 patients, 15 had CCR ≤ 0.04 and out of these, 10 (66.67%) had developed preeclampsia later on. On the contrary, out of 85 patients with CCR> 0.04, only 5 (5.8%) had preeclampsia and remaining 80 patients did not have preeclampsia.Conclusion. Measurement of urinary calcium creatinine ratio is a non-invasive, inexpensive and easy to carry out method. It can be used as early predictor to identify pregnant women having high risk of developing preeclampsia and thereby help in initiating prompt education of the patients and timely prophylactic interventions, thus minimizing the severity of preeclampsia.
Authors and Affiliations
Dr Akriti Prasad, Dr Anita Kumari Murmu, Dr Amrita Sharan
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