Urinary Uric Acid/Creatinine Ratio - A Marker For Perinatal Asphyxia
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 1
Abstract
Background: Perinatal hypoxia is one of the leading causes of perinatal mortality in developing countries. Both apgar score and arterial blood pH predict the neonatal mortality in asphyxia. Apgar score alone does not predict neurologic outcome and as it is influenced by various factors. This study was conducted to evaluate the utility and sensitivity of urinary uric acid to creatinine ratio (UA/Cr ratio) in asphyxia diagnosis, compared to invasive Arterial Blood Gas (ABG) analysis. Aim: To assess the urinary uric acid/creatinine ratio as an additional marker for perinatal asphyxia compared with ABG analysis in apgar score monitoring. Materials and Methods: The present case control study was conducted at a teaching hospital in Central Gujarat. Data of 40 healthy newborns and 40 asphyxiated newborns were collected. In absence of regional estimates, a sample of size 39 was required to attain a power of 80% at 5% alpha (type I error) considering a moderate effect size of 0.65. (UA/Cr) ratio was measured from the spot urine sample collected during 24-72 hours of birth. Statistical analysis was performed by Independent t-test, Pearson’s correlation coefficient (r) and Receiver Operating Characteristic (ROC) plots. Results: The mean (UA/Cr ratio) (2.75±0.18 vs 1.78±0.23) is significantly higher in asphyxiated group than in the control group (p<0.0001). Urinary UA/Cr ratio had negative correlation with blood pH (r= -0.27, p=0.18), which was not significant (p>0.05). Urinary UA/Cr ratio with criterion of >2.3 had 100% sensitivity, 100% specificity with AUC of 1 (p<0.0001) had a better predictive value. Conclusions: Apgar score is usually reduced in neonates with congenital anomalies and premature neonates. Hence, it is preferable that the clinical diagnosis of asphyxia by apgar scores be supported by other investigations so that early decision can be taken about the level of care the baby needs. pH, lactates and base deficits change with establishment of respiration following resuscitation. However, pH, lactate, base deficit estimations are invasive and need rapid estimations. Non-invasive urinary UA/Cr ratio may be an answer to these issues as it easy, economical and equally efficient.
Authors and Affiliations
Kinjal Prahaladbhai Patel, Mayur Goradhanbhai Makadia, Vishwal Indravardan Patel, Haridas Neelakandan Nilayangode, Somashekhar Marutirao Nimbalkar
Keywords
Related Articles
- EP ID EP328509
- DOI 10.7860/JCDR/2017/22697.9267
- Views 157
- Downloads 0
Need for Changes in the Practical Physiology Curriculum of Medical Undergraduates
Introduction: Physiology is one of the foundation sciences for the medical curriculum. It forms the basis of all life sciences. Physiology practical classes in India are divided into three sections: exercises in haematol...
Pseudomyxoma Peritonei Secondary to Rupture of Intraductal Papillary Neoplasm of Pancreas (IPMN)
ABSTRACT Pseudomyxoma peritonei is the intraperitoneal accumulation of a gelatinous ascites secondary to mucinous tumour rupture, more commonly associated with ovarian and appendiceal mucinous tumour. However, pancreatic...
Barriers to Stroke Thrombolysis
Introduction: Thrombolytic therapy with intravenous recombinant tissue plasminogen activator (rt-PA) is the cornerstone of acute ischaemic stroke treatment. The number of stroke patients receiving thrombolytic therapy in...
Socket Preservation using Platelet Rich Fibrin for Pink Aesthetics- A Case Report
ABSTRACT Post extraction preservation of interdental papillae, poses a challenge to the clinicians exclusively when related to the restoration of missing anterior teeth. In the modern era, patients claim for aesthetics,...
Influence of BMI on Cardiac Output and Peripheral Blood Flow in Young Adult Males
ABSTRACT Introduction: Obesity is increasing at an alarming rate in young population which has a direct effect on their cardiovascular health resulting in development of hypertension, dyslipidaemia and peripheral vascula...