Modak, RupaliPal, AmitrajitPal, AmitavaGhosh, Mrinal K.2020-10-162020-10-162020-02Modak Rupali, Pal Amitrajit, Pal Amitava, Ghosh Mrinal K.. Prediction of preeclampsia by a combination of maternal spot urinary protein-creatinine ratio and uterine artery doppler. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2020 Feb; 9(2): 635-6392320-17702320-1789http://imsear.searo.who.int/handle/123456789/207415Background: Preeclampsia (PE) is heterogeneous disorder. The aim of the study was to observe the role of a spot urinary protein - creatinine ratio (UPCR) and uterine artery doppler velocimetry measured between 20-24 weeks of gestation in prediction of preeclampsia.Methods: Prospective observational study conducted on 120 pregnant mothers with singleton pregnancy between 20-24 weeks of gestational age in two tertiary teaching hospitals in eastern India. A spot urinary protein creatinine ratio (UPCR) was determined in a mid- stream urine sample and estimation of protein was done by immunoturbidimetric micro albumin method and creatinine by modified Jaffe’s method. Doppler velocimetry was also determined at 20-24 weeks of gestation. A notch in uterine artery, unilateral or bilateral; or RI > 0.7 and PI of > 1.45 were considered to have an abnormal result. Women were followed-up and relationship between variables was assessed by Chi- square test.Results: Women who subsequently developed preeclampsia had significantly higher UPCR (median 44.8 mg/mmol) when compared with women of unaffected groups (median 26.6 mg/mmol). The optimum spot urinary UPCR to predict preeclampsia was 35.5 mg/mmol and the cut-off value >35.5 mg/mmol had a test sensitivity (80%), specificity (94.06%), PPV (66.76%) and NPV (96.94%).The area under curve (AUC) of spot UPCR in ROC curve was  0.949 (95% CI,0.891 - 1.000). For predicting preeclampsia, the mean uterine artery RI had to be >0.7 having sensitivity (60%), specificity (97.03%), PPV (75%) and NPV (94.23%). The area under curve (AUC) was 0.856 (95% CI, 0.742 - 0.971).Conclusions: Second trimester UA doppler is a useful screening test for prediction of preeclampsia. This test works best when combined with a spot UPCR and accuracy of both the methods for prediction of preeclampsia was 92.24%.Pre-eclampsiaPredictionUrinary protein-creatinine ratioUterine artery dopplerJournal ArticleIndiaDepartment of Obstetrics and Gynecology, R.G. Kar Medical College, Kolkata, West Bengal, IndiaDepartment of Pharmacology, Grant Medical College, Mumbai, Maharashtra, IndiaDepartment of Obstetrics and Gynecology, Burdwan Medical College, Purba Barddhaman, West Bengal, IndiaDepartment of Radio Diagnosis, Burdwan Medical College, Purba Barddhaman, West Bengal, India