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Background: Although, twenty-four hour urine collection was considered the gold standard for quantification of proteinuria, it has many limitations. It is cumbersome for the patient and often inaccurate because of under collection and result availability is delayed for at least 24 hours. The spot albumin creatinine (A/C) ratio use in pregnancy has been extensively studied. Its use has been adopted by some authors as they found that it had been significantly correlated to 24 hour urinary protein estimation while others did not support its use as in cases of preeclampsia kidney function may deteriorate rapidly. Objective: To evaluate the accuracy of random urine albumin/ creatinine ratio as a diagnostic method for quantitative evaluation of proteinuria in hypertensive disorders in pregnant women. Methods: A total of 70 patients fulfilling inclusion criteria were evaluated with urine albumin/creatinine ratio performed on random voided sample. The entire 24 hour urine sample was collected and analyzed for daily protein excretion. A/C ratio was compared to the 24 hour results. Results: There was significant positive correlation detected between A/C ratio and 24 hour protein at a cutoff value of 347.35 mg/gm. Area under curve for A/C ratio was 0.730 (P<0.001) showing sensitivity 80.6% and specificity 51.2% to detect protein excretion of 300 mg/24 hr. While, there was significant negative correlation detected between A/C ratio and urine creatinine. Conclusion: Random A/C ratio could be used as a rapid, easy and reliable test for diagnosis of significant proteinuria in hypertensive disorders with pregnancy, so it can substitute 24 hour urinary protein collection. Goetz Egloff1*, Isabella Bender2, and Jasmin Roemer3 Amr Ahmed Abdelrhman* and Ahmed Mahmoud Abdou Lecturer of Obstetrics and Gynecology, Faculty of medicine, Zagazig University, Egypt *Address for Correspondence Amr Ahmed Abdelrhman, Lecturer of Obstetrics and Gynecology, Faculty of medicine, Zagazig University, Egypt, Tel: +2 01111222964; E-mail: amrabdelrahman@medicine.zu.edu.eg Submission: 11 June, 2018 Accepted: 13 July, 2018 Published: 20 July, 2018 Copyright: © 2018 Abdelrhman AA, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Research Article Open Access been extensively studied. Its use has been adopted by some authors as they found that it had been significantly correlated to 24 hour urinary protein estimation and in cases of preeclampsia kidney function may deteriorate rapidly while others did not support its use [4]. Both spot albumin/creatinine ratio and spot protein/creatinine ratio had been thoroughly evaluated and used in non-pregnant women. The National Kidney Foundation adopted these tests to evaluate proteinuria in most conditions instead of 24 hour urine collection [5]. The Society of Obstetricians and Gynecologists of Canada, the Society of Obstetric Medicine of Australia and New Zealand and the International Society for the Study of Hypertension in Pregnancy have adopted the spot urine ACR as a practical method for the detection of significant proteinuria (≥0.3 gm/24 hr.) during pregnancy, but this is not proved by other international groups like the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy and American Congress of Obstetricians and Gynecologists [6]. The aim of this study is to evaluate the accuracy of spot urine albumin/ creatinine ratio as a diagnostic method for quantitative assessment of proteinuria in hypertensive disorders in pregnant women. Patients and Methods Seventy pregnant women with hypertensive disorders with pregnancy were included in the study at the department of Obstetrics and Gynecology, Zagazig University Hospitals from January 2016 to June 2017. An informed signed consent about the aim of the study, the required procedure and the follow-up plan was obtained from each woman. We exclude patients with a known kidney disease, Presence of bacteriuria, Pregestational and gestational diabetes mellitus, women delivered their babies during the urine collection day. All pregnant women who were included in the study were subjected to: 1. Full history taking, which included personal history, obstetric history, menstrual history, present history, previous and present medical diseases (cardiac, hepatic, renal, endocrinal, pulmonary) and family history of diabetes mellitus and hypertension. Introduction Preeclampsia is a multisystem disease defined as gestational hypertension with proteinuria or defective placental angiogenesis so, the quantification of proteinuria in preeclampsia is mandatory for diagnosis of the disease [1]. Significant proteinuria is defined by 24 hour urinary protein more than 300 mg/dl or persistent 30 mg/dl in random urine samples [2]. Twenty-four hour urine collection, although the gold standard for estimation of proteinuria has some constraints. It is cumbersome for the patient and often inaccurate because of under collection, and result is delayed for at least 24 hours also [3]. The degree of proteinuria show significant fluctuation throughout the day, even in severe cases. Therefore, significant proteinuria cannot be detected by a single random urinary sample [3]. The spot albumin creatinine (A/C) ratio use in pregnancy has Journal of Andrology & Gynaecology Avens Publishing Group Inviting Innovations J Androl Gynaecol July 2018 Vol.:6, Issue:1 © All rights are reserved by Abdelrhman, et al.

Urinary Spot Albumin/Creatinine Ratio for Documenting Proteinuria in Women with Hypertensive Disorders with Pregnancy