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
Background: Young maternal age is variously defined in studies of its effect on obstetrics and perinatal outcomes. Also, pregnancy has been reported as the leading cause of death in adolescent girls in low-and middle-income countries. Aims: The aim of the study was to evaluate whether young maternal age was associated with an increased risk of obstetrics and perinatal adverse outcomes. Study Design: Case-control study. Methods: This case-control study was derived from a database of the medical records between January 2008 and December 2012. In the present study, 1374 teenage pregnancy and 1294 adult pregnancy cases were included. After restriction of analyses to singleton primiparous women, 1282 teenage pregnancy and 735 adult pregnancy cases were analyzed. Maternal age was separated into three groups: 15 and less, 16-19, and 20-34 years. Adjusted odds ratios (ORs) were derived through logistic regression models for the potential confounding factors. Results: Adolescents aged 15 years and younger had higher risks of preterm delivery, early preterm delivery, intrauterine fetal death and neonatal death compared with women aged 20 to 34 years after adjustment for confounding factors. In addition, both groups of adolescents had higher risks for anemia and episiotomy and lower risk of cesarean delivery. The rates of preeclampsia, gestational diabetes, chronic diseases, intrauterine growth restriction (IUGR) were higher in the adult group. Adolescent pregnancy is defined as pregnancy in girls aged less than 20 years. It is estimated that 16 million 15-19 yearold women give birth every year, accounting for approximately 11% of all births worldwide (1). In low-and middle-income countries, pregnancy has been reported as the main factor of death in adolescent girls (1). Young maternal age has usually been considered a high risk in relation to adverse pregnancy outcomes (1-16). Possible explanations for adverse pregnancy outcomes have been thought to be their biological immaturity or poor social, economic and behavioral factors such as smoking, alcohol/substance abuse, malnutrition and inadequate prenatal care (17-22). However, the previous studies had conflicting findings regarding whether the effect of young maternal age on adverse pregnancy outcomes were caused by their biological immaturity or poor social, economic and behavioral factors (17)(18)(19)(20)(21)(22). ConclusionThe aim of the present study was to investigate whether there is an association between young maternal age and poor maternal and perinatal outcomes independent of possible confounding factors.
Background: Young maternal age is variously defined in studies of its effect on obstetrics and perinatal outcomes. Also, pregnancy has been reported as the leading cause of death in adolescent girls in low-and middle-income countries. Aims: The aim of the study was to evaluate whether young maternal age was associated with an increased risk of obstetrics and perinatal adverse outcomes. Study Design: Case-control study. Methods: This case-control study was derived from a database of the medical records between January 2008 and December 2012. In the present study, 1374 teenage pregnancy and 1294 adult pregnancy cases were included. After restriction of analyses to singleton primiparous women, 1282 teenage pregnancy and 735 adult pregnancy cases were analyzed. Maternal age was separated into three groups: 15 and less, 16-19, and 20-34 years. Adjusted odds ratios (ORs) were derived through logistic regression models for the potential confounding factors. Results: Adolescents aged 15 years and younger had higher risks of preterm delivery, early preterm delivery, intrauterine fetal death and neonatal death compared with women aged 20 to 34 years after adjustment for confounding factors. In addition, both groups of adolescents had higher risks for anemia and episiotomy and lower risk of cesarean delivery. The rates of preeclampsia, gestational diabetes, chronic diseases, intrauterine growth restriction (IUGR) were higher in the adult group. Adolescent pregnancy is defined as pregnancy in girls aged less than 20 years. It is estimated that 16 million 15-19 yearold women give birth every year, accounting for approximately 11% of all births worldwide (1). In low-and middle-income countries, pregnancy has been reported as the main factor of death in adolescent girls (1). Young maternal age has usually been considered a high risk in relation to adverse pregnancy outcomes (1-16). Possible explanations for adverse pregnancy outcomes have been thought to be their biological immaturity or poor social, economic and behavioral factors such as smoking, alcohol/substance abuse, malnutrition and inadequate prenatal care (17-22). However, the previous studies had conflicting findings regarding whether the effect of young maternal age on adverse pregnancy outcomes were caused by their biological immaturity or poor social, economic and behavioral factors (17)(18)(19)(20)(21)(22). ConclusionThe aim of the present study was to investigate whether there is an association between young maternal age and poor maternal and perinatal outcomes independent of possible confounding factors.
Lidocaine infiltration at port sites had beneficial effects on pain intensity in the early postoperative period after laparoscopic gynecological surgery. However, the results of present study showed that the analgesic effect mechanism of local anesthetic was unrelated to the preemptive analgesia hypothesis.
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