title: Prediction of pre-eclampsia: comparative analysis of two screening tests.
abstract: Pre-eclampsia is a major cause of maternal and perinatal morbidity and mortality. Unfortunately, in spite of extensive research worldwide, still we lack an effective screening test for pre-eclampsia. The aim of the current study is to assess the importance of micro-albuminuria and uterine artery Doppler resistance index as a screening test for pre-eclampsia during antenatal period. The study is a prospective audit. The study population consisted of 160 antenatal mothers attending the outpatient department. Test for micro-albuminuria was done at 14 weeks, 18 weeks, 28 weeks and 34 weeks of gestation. Uterine artery Doppler resistance index (0.58 taken as cut-off) was recorded at 18 weeks of gestation. The subjects were followed up till delivery for development of pre-eclampsia. Sensitivity, specificity, positive and negative predictive value (along with confidence interval and diagnostic odd's ratio) of the tests were calculated. Sensitivity, specificity, positive and negative predictive value of micro-albuminuria was recorded as 66.67%, 93.24%, 44.44% and 97.18% respectively. Those of uterine artery Doppler resistance index were 33.33%, 95.96%, 40% and 94.67% respectively. Diagnostic odd's ratio of micro-albuminuria and uterine artery Doppler resistance index were 27.600 and 11.833 respectively. Confidence interval and diagnostic odd's ratios show that uterine artery Doppler study is a better screening test amongst the two. Both the tests being non-invasive in nature and having high specificity and high negative predictive value can be utilised in community-based antenatal care for identifying women who need intensive vigilance.
authors.affiliation: Department of Obstetrics and Gynaecology, Institute of Postgraduate Medical Education & Research, Kolkata 700020.
authors.forename: Amitava
authors.initials: A
authors.lastname: Mukhopadhyay
authors.forename: Parsotam
authors.initials: P
authors.lastname: Sharma
authors.forename: Shyamal
authors.initials: S
authors.lastname: Dasgupta
authors.forename: Subhankar
authors.initials: S
authors.lastname: Dasgupta
authors.forename: Partha Pratim
authors.initials: PP
authors.lastname: Sharma
authors.forename: Tarun Kumar
authors.initials: TK
authors.lastname: Ghosh
mesh_terms: D000419:Albuminuria / Q000175:diagnosis*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000517:prevention & control* / Q000652:urine; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D014655:Vascular Resistance