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A comparison of the inactive urinary kallikrein:creatinine ratio and the angiotensin sensitivity test for the prediction of pre‐eclampsia
Author(s) -
Kyle Phillips M.,
Campbell Sarah,
Buckley Davina,
Kissane Jennifer,
Swiet Michael,
Albano Janet,
Millar J. Gavin,
Redman Christopher W. G.
Publication year - 1996
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1996.tb09547.x
Subject(s) - medicine , eclampsia , aspirin , gestation , placebo , pregnancy , urinary system , preeclampsia , population , creatinine , obstetrics , urology , gynecology , pathology , genetics , alternative medicine , environmental health , biology
Objective To determine the relation between the inactive urinary kallikreimcreatinine ratio (IUK:Cr) and the angiotensin sensitivity test (AST) at 28 weeks of gestation and to assess each as a screening test for pre‐eclampsia. Design Prospective interventional study. Subjects Four hundred and fifty‐nine normotensive nulliparous women recruited from hospital antenatal clinics. Setting John Radcliffe Maternity Hospital, Oxford, and Queen Charlotte's and Chelsea Hospital, London. Interventions A urine sample for IUK:Cr measurement was provided before performing the AST at 28 weeks of gestation. Those women who demonstrated increased sensitivity to angiotensin II were entered into a randomised placebo controlled trial of low dose aspirin for the prevention of pre‐eclampsia (CLASP). Main outcome measures The development of pre‐eclampsia. Results The IUK:Cr ratio was significantly lower in those women who showed increased sensitivity to angiotensin II ( P < 0.0001 Student's t test). The sensitivity and specificity for detecting pre‐eclampsia were, respectively, 22% and 85% for the AST and 67% and 75% for the IUK:Cr. Low‐dose aspirin (60 mg) had no effect on the pregnancy outcome. Conclusion There appears to be some relation between the IUK:Cr and AST tests in pregnancy. However, in this population, the IUK:Cr ratio was a better screening test for pre‐eclampsia than the AST, but overall neither test was a powerful predictor for the syndrome.