Spot protein to creatinine ratio a good alternative to 24 hour urinary protein for diagnosis of preeclampsia

Objective: To determine the validity of protein to creatinine ratio in comparison to 24-hour urine protein estimation in the diagnosis of preeclampsia. Methodology: 150 pregnant women with preeclampsia defined as a BP > 140/90 and 1+ proteinuria at a gestational age > 20 weeks were recruited through outpatient department by performing a dipstick examination. A spot Protein creatinine ratio was done on mid-stream urine sample on the same day after admission. From the next voided specimen urine was collected for determination of 24 hrs urinary proteins. Results: The mean age of the patients was 27.56±4.4 years and the mean gestational age was 34.9±2.87 weeks. 115 (76.67%) patients had positive 24-hour urine protein test for significant proteinuria. Out of these 115 (100%) also had a positive spot urine protein creatinine ratio test and none (0%) had a negative spot urine protein creatinine ratio test. Out of 150 patients, 35 (23.3%) had negative 24-hour urine protein test for significant proteinuria. Out of these, 1 (2.8%) had a positive spot urine protein creatinine ratio test and 34 (97.2%) had a negative spot urine protein creatinine ratio test (spot urine protein creatinine ratio test accuracy 99.3%). The calculated sensitivity and specificity of the Spot urine protein creatinine ratio test in comparison to 24-hour urine protein test was 100% and 97.14%, respectively. Positive predictive value (PV+) and negative predictive value (PV−) was found to be 99.1% and 100%, respectively. Conclusion: Protein creatinine ratio in spot urine spe¬cimens is an accurate method and a good alternative to estimate the protein excretion in cases of preeclampsia.