تقييم دور بروتين عامل نمو بطانة الاوعية الدموية ونسبة الصوديوم, البوتاسيوم, والكالسيوم الى الكرياتينين في الادرار كفحص تشخيصي لمرضى ما قبل تسمم الحمل == The Role of Vascular Endothelial Growth Factor and Urinary Sodium, Potassium, and Calcium to Creatinine Ratio as Diagnostic Tests in Pre - eclampsia
Author name:
غيث كامل جواد
Supervisor name:
حيدر هاشم الشلاه | ملال محمد الجبوري
General topic:
Medicine
Specific topic:
Clinical Biochemistry
Degree:
Master
University:
University of Babylon - Faculty Of Medicine
Language:
English
University location:
Babylon
First pages:
19T1256 - p.pdf
Abstract:
Preeclampsia is defined as hypertension associated with proteinuria arising de novo after the 20th week of gestation in a previously normotensive woman and resolving completely by the 6th postpartum week.It is a major cause of morbidity and mortality during pregnancy. There are many ways to diagnose the disease, based on clinical diagnosis and conduct some tests; screening tests measurement of the amount of protein found in the urine sample that had been collected for a period of twenty - four hours. In the present study, the ratio of (Na+, K+, and Ca++) to creatinine in the urine spot sample, in addition to the protein vascular endothelial growth factor in the serum were measured as an attempt to be used as screening or diagnostic tests for patients with pre - eclampsia. This study was carried out at Babylon Teaching Hospital for Gynecology and Pediatrics, in Babylon Province, Hilla City during the period between February 2016 till August 2016. This study included 88 women, 44 were patients diagnosed with preeclampsia in the second and third trimester and the other 44 were healthy pregnant women in the same period of pregnancy taken as a control. Cases with age over 135 year, BMI > 300, previous historyd of pre - eclampsia, family history of pre - eclampsia, multipled pregnancy and hydrops fetalis, pre - existing hypertension or renal disease, pre - existing vascular disease, and antiphospholipid syndrome were excluded. Serum levels of vascular endothelial growth factor were measured by using ELISA technique, while urine were collected to estimate calcium and creatinine by spectrophotometric method. Sodium and potassium by ion selective electrode technique. The ratio of sodium to creatinine, potassium to creatinine, and calcium to creatinine were calculated.Serum vascular endothelial growth factor level was significantly lower in patients with preeclampsia compared to control group (P value < 0.01).The sensitivity of VEGF to detect preeclampsia was (75%) while, it's specificity was (90.9%).Similarly, the urinary Na+/creatinine ratio and Ca++/ creatinine ratio was significantly lower in patients with pre - eclampsia compared to control groups (P value < 0.01). The sensitivity of urinary Na+/Creatinine ratio was (93%) and it's specificity was (70%). While the sensitivity of urinary Ca++/ creatinine ratio was (34%) and specificity was (97%).On the other hand, urinary K+/creatinine ratio was significantly higher in patients with pre - eclampsia compared to control groups (P value < 0.01).The sensitivity of urinary K+/creatinine ratio to detect pre - eclampsia was (77%) while, its specificity was (68%).This study concluded that urinary Na+/creatinine ratio can be used as a screening tests because of excellent sensitivity, however because of excellent specificity of vascular endothelial growth factor and urinary Ca++/creatinine ratio (90.9% and 97% respectively), they are convienent for diagnostic purpose.
