Title: A Prospective study to evaluate the role of urinary Calcium Creatinine Ratio (CCR) in early prediction of pre-eclampsia
Authors: Dr Nikita, Dr Anju Sharma, Dr Lata Rajoria, Dr Megha Agarwal, Dr Charusmita Agarwal, Dr Yashwant
DOI: https://dx.doi.org/10.18535/jmscr/v7i1.108
Abstract
Background: Preeclampsia is associated with hypocalciuria due to derangement in calcium metabolism associated with this condition. Urinary calcium Creatinine ratio is easily measurable, most effective then with spot urine sample compared with other methods that are expensive, time consuming, required specialized equipment & involving complex procedures. The present study will help us in evaluating the role of urinary calcium Creatinine ratio as an effective screening method for prediction of preeclampsia.
Material & Methods: A Hospital based prospective study done on 80 women who attended the department of Obstetrics and Gynaecology, SMS medical college, Jaipur for routine antenatal care, over a period of 1 year between 16-20 weeks of gestation were included in the study after obtaining informed consent. A spot urine sample was collected for estimation of calcium and creatinine. Calcium was determined by O Cresolphthalein complex reaction and creatinine was estimated by Jaffes method. All these women were followed up till delivery.
Results: The gestational age at weeks in study group was 37.07 weeks & 43.48 weeks in control group. Majority of cases had normal delivery in both groups (85%). Only 15% patients had cesarean delivery, out of which 4 in pre-eclampsia patients and 8 in normal patients. The sensitivity of CCR test was found to be 92.85% and specificity 95.45%. The positive predictive value was 81.25 and the negative predictive value was 98.43.
Conclusion: Screening test for preeclampsia is very essential to prevent complications of preeclampsia, which is a major cause for maternal and fetal mortality and morbidity.
Keywords: Preeclampsia, Urinary calcium Creatinine ratio, Morbidity, mortality.
References
- Suarez VR, Trelles JG, Miyahira JM. Urinary calcium is asymptomatic primigravidas who later developed pre eclampsia. Obstet Gynecol 1996;87(l):79- 82.
- Rodriguez MH, Masaki DI, Mestman J, Kumar D, Rude R. Calcium/creatinine ratio and microalbuminuria in the prediction of preeclampsia. Am J Obstet Gynecol 1988;159(6):1452–5.
- Ozcan T, Kaleli B, Ozeren M, Turan C, Zorlu G, Dr. Zekai Tahir Burak Maternity Hospital, Ankara, Turkey. Urinary calcium to creatinine ratio for predicting preeclampsia. Am J Perinatol. 1995;12(5): 349-51.
- Dasgupta M, Adhikary S, Mamtaz S. Urinary calcium in preeclampsia. Indian J Obstet Gynecol. 2008;58:308–13.
- Kazerooni, T. and S. Hamze-Nejadi, 2003.Calcium to creatinine ratio in a spot sample of urine for early prediction of pre-eclampsia. Int. J. Gynecol. Obstet., 80: 279-283.
- Kar J, Srivastava K, Mishra RK, Sharma N, Pandey ON, Gupta Shalini. Role of urinary calcium creatinine ratio in prediction of pregnancy induced hypertension. J Obstet Gynecol Ind.2002; 52(2): 39-42.
- Suzuki Y, Hayashi Y, Murakami I, Yamaguchi K, and Yagami Y. Urinary calcium excretion as an early prediction marker for pregnancy induced hypertension. Nippon Sanka Fujinika Gakkai Zasshi. Nov 1992; 44(11): 1421- 1426
- Sheela CN, Beena SR, MhaskarArun. Calcium- Creatinine Ratio and Microalbuminuria in Prediction of Pre-eclampsia. The Journal of Obstetrics and Gynaecology of India January/ February 2011 pg 72 – 76.
- Saudan PJ, Shaw L, Brown MA. Urinary calcium / creatinine as a prediction of preeclampsia. Am J Hypertens 1998; 11 (7):839-43.