Evaluation of the correlation between spot urinary protein/creatinine ratio and serum uric acid and its association with feto-maternal outcome in hypertensive pregnancy

Abstract

Background: Hypertension complicating pregnancy affects almost 7-15% of all gestations and accounts for approximately one-fourth of all antenatal admissions. Serum uric acid is a predictor of oxidative stress, tissue injury and renal impairment, and thus may be useful in detecting preeclampsia complications. The Spot Urinary Protein / Creatinine Ratio (P/C) predicts with high accuracy the amount of urinary protein excretion 24 hours a day. Objective: To study the Spot Urinary P/C Ratio and Serum Uric Acid levels as prognostic indicators and their effect on feto-maternal outcome in females with singleton pregnancy suffering from pre-eclampsia. Methodology: A basic head to toe examination followed by a systemic examination of CVS and RS system would be done. BP values would be recorded for all cases and controls at 4 hourly intervals. A complete obstetric examination will be conducted to clinically assess various maternal and fetal parameters. Investigations will include complete blood count (CBC), liver function test, kidney function tests, Urine test, and level of uric acid and lactate dehydrogenase (LDH). Clinical follow up till of all cases till delivery to look for progression of preeclampsia/eclampsia. Involvement of other organ systems will be noted if any. Results: There exists a positive correlation between Spot Urinary P/C Ratio and Serum Uric Acid and adverse feto-maternal outcome. Conclusion: Urine collection is easy and hassles free in addition to being non-invasive and cost-effective. It requires simple instruction for collection. Hence, Spot Urinary P/C Ratio and Serum Uric Acid is a useful approach for monitoring women with pre-eclampsia at community and hospital setting.