INTRODUCTION

Hypertension disorders in pregnancy cause significant number of maternal morbidity and mortality. In local statistics for the years 2019–2022, hypertension causes 13.8% of the maternal mortality. Thus, accurate diagnosis of Preeclampsia is crucial to prevent disease progression and to provide timely intervention for improved maternal outcomes. It is widely accepted that 24-h urine protein is the gold standard for detecting proteinuria in patients with preeclampsia, but since the process of collection is too long and complicated, recent studies focus on other less complex yet reliable methods of determining proteinuria for the diagnosis of preeclampsia, including the protein–creatinine ratio (PrCr) dipstick tests.

GENERAL OBJECTIVE

This study aims to determine the diagnostic accuracy of urine protein detection in patients with preeclampsia, using a urine PrCr dipstick test.

MATERIALS AND METHODS

A prospective, cross-sectional study using purposive sampling was used in this study. A total of 153 admitted pregnant patients with gestational hypertension and preeclampsia, without other comorbidities or significant past medical history, were tested for proteinuria using the 24-h urine protein test and urine PrCr dipstick test. Statistical analysis to assess diagnostic accuracy used was the sensitivity, specificity, positive predictive value, and negative predictive value.

CONCLUSIONS

The urine PrCr dipstick test has comparable diagnostic accuracy with 24-h urine protein test in detecting proteinuria, with a sensitivity of 88%, a specificity of 64%, and a high positive predictive value of 94%. It is a simpler, faster, yet useful alternative to a more tedious, time and resource consuming process of urine collection in the 24-h urine protein in identifying patients with proteinuria, and therefore, preeclampsia.

Human ; Pre-eclampsia ; Proteinuria

OBJECTIVES: The objective of this study was to determine the most accurate method to use for the diagnosis of membrane rupture as well as to compare the sensitivity, specificity, positive and negative predictive values of such different methods.

METHODOLOGY: This prospective, non-randomized, descriptive study included 100 subjects, 50 each for the control group or women with intact membranes documented by history and physical examination, and gold standard group or women with ruptured membranes documented by history and pooling of amniotic fluid on speculum examination. Endocervical samples for control group (no pooling) and vaginal/posterior fornix samples for gold standard group (with pooling of fluid) were obtained from each patient used to test for determination using Actim^TM PROM test kit, ferning test, and pH testing using litmus paper.

RESULT: Ferning's test, Litmus paper test and Actim^TM PROM test have sensitivity of 30%, 44% and 74%, respectively specificity of 100%, 96%, 96% and respectively; PPV of 100%, 91.7% and 94.9% respectively; and NPV of 58.8%, 63.2% and 78.7% respectively. Actim PROM test kit was noted to be superior in terms of accuracy, followed by Litmus paper test, and lastly, by Ferning test as shown by the Receiver Operating Characteristic curve.

CONCLUSIONS: Actim^TM PROM test was noted to have the highest accuracy, as evidenced by the result of ROC curve, with the highest probability of testing positive in patients with true rupture of membranes, and with the highest Kappa statistic value or lowest probability of having interobserver variability.

Human ; Female ; Adult ; Fetal Membranes, Premature Rupture-diagnosis ; Preterm Premature Rupture of the Membranes