A Hospital Based Prospective Study 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 16 to 24 Weeks of Gestation

Abstract

Background: Hypertensive disorder of pregnancy are one of the major causes of maternal and fetal mortality and morbidity. During pregnancy, by increasing intestinal absorption, decreasing renal calcium loss, and reabsorbing some calcium from the maternal skeleton the woman's body undergoes physiological compensation. The aim of this study to determine the efficacy of urinary calcium to creatinine ratio in a spot urine sample for the prediction of preeclampsia in a asymptomatic pregnant women between 16 to 24 weeks of gestation. Materials& Methods: A hospital based observational prospective study done on hundred primigravida / multigravida with singleton pregnancy within the gestational age of 16-24 weeks who came for regular ANC to OPD in government district hospital, Sirohi, Rajasthan, India during one year period. Urine Calcium-to-creatinine ratio (CCR) was calculated, and those with a ratio of less than or equal to 0.04 were considered as test positive. Descriptive statistics frequency analysis was used to describe about the data, percentage analysis were used for categorical variables and for continuous variables the mean & S.D were used. Results: The incidence of Preeclampsia was 15% and that of normotensive pregnant women was 85%. Amongst the patients who had a Urine Ca/Cr ratio <0.04, 15 women constituting 88.23% developed preeclampsia whereas 2 patients constituting 11.76% remained normotensive at term gestation. Conclusion: We conclude that a pregnant woman with a high risk factor such as nulliparity along with low urinary CCR is at high risk for development of preeclampsia. Therefore, a single urinary calcium to creatinine ratio may be an effective screening method for impending preeclampsia and may identify population at greater risk to be included in primary prevention programmers’