Emergency peripartum hysterectomy is significantly related to CS in index or previous pregnancy. Placenta accreta is the most common indication to perform peripartum hysterectomy. EPH is associated with a high incidence of maternal morbidity and mortality.

Background: Proteinuria is a major component of preeclampsia. Urine protein measurement after 24-hour urine collection is the traditional standard method for the detection of proteinuria. It is timeconsuming. As an alternative, random spot sampling for a urine protein to creatinine (P/C) ratio has been investigated. Aims: The aim of the study was to determine the diagnostic accuracy of the protein to creatinine ratio (P/C) compared with 24-hour urine collection for the detection of remarkable proteinuria and to evaluate the P/C ratio for different proteinuria ranges in patients with preeclampsia. Study Design: Case-control study. Methods: Two hundred and eleven pregnant women who met the criteria of preeclampsia comprised the study group and fifty three pregnant women were taken as the control group. Spot urine specimens for measuring P/C ratio were obtained taken immediately before 24-hour urine collection. The correlation between the P/C ratio in the spot urine samples and urinary protein excretion in the 24-hour collections was examined using the Spearman correlation test. Results: It was found a good positive correlation between the P/C ratio and 24-hour protein excretion, with a correlation coefficient (r) of 0.758. The best cut-off which gave the maximum area under the curve was 0.45 for 300 mg, 0.9 for 1000 mg, 1.16 for 2000 mg, 1.49 for 3000 mg, 2.28 for 4000 mg and 2.63 for 5000 mg per 24h. A P/C ratio above 0.9 strongly predicts significant proteinuria for more than 1 gram (AUC 0.97, 95% CI: 0.94-0.99 and sensitivity, specificity, positive and negative predictive value of 91%, 95.4%, 95.2%, and 91.2%, respectively). Conclusion:The P/C ratio can be used as a screening test as a good predictor for remarkable proteinuria. The P/C ratio seems to be highly predictive for diagnosis to detect proteinuria over one gram and it could be used as a rapid alternative test in preeclamptic patients not to delay implementation treatment. Keywords: Preeclampsia, proteinuria, urine proteincreatinine ratio : 27.05.2014 Accepted: 26.11.2014 • DOI: 10.5152/balkanmedj.2015 Increased rate of maternal and fetal mortality and morbidity(1, 2) is associated with preeclampsia. Proteinuria is a main component of preeclampsia and one of the diagnostic criteria of its severity. Protein measurement in the 24-hour urine sample is the traditional standard method for the detection of proteinuria (3). Twenty-four-hour urine collection is timeconsuming and inconvenient, and results may be inaccurate when the collection of urine is missed, depending upon the individual. The management of patients may be delayed during the urine collection. A more rapid test that enables the accurate

US has very high sensitivity and low false-positive rates in identifying fetal teratoma prenatally. The risk of chromosomal abnormalities is very low in fetuses with teratoma, and their prognosis depends on the location and size of the tumor and any associated perinatal complications.

Early pregnancy dyslipidemia, particularly hypertriglyceridemia appears associated with increased risk of pre-eclampsia.

Vaginal delivery of 1,000-1,500 g babies presenting as breech is associated with the increased neonatal mortality compared with cesarean delivery. Cesarean delivery is associated with maternal morbidity compared with the vaginal delivery.