The significance of serum uric acid, creatinine and urinary microprotein levels in predicting pre-eclampsia.

The object of this study was to determine whether serum uric acid, serum creatinine and urinary microprotein levels could be used to identify women who might subsequently develop pre-eclampsia during pregnancy. This is a cross-sectional descriptive study performed on women attending the University antenatal clinic in Colombo South Teaching Hospital, Sri Lanka. Serum uric acid, creatinine and microproteinuria levels were determined in 256 women attending the antenatal clinic at 28 weeks of pregnancy. Subsequently they were followed-up at 2-weekly intervals until 36 weeks and weekly thereafter until delivery. At each visit blood pressure was recorded and serum uric acid, creatinine and microprotein levels were determined. Fifty-nine women developed blood pressures of 140/90 mmHg or more during the study period. Serum uric acid and serum creatinine levels did not show any significant difference before the elevated blood pressures were recorded. Microprotenuria levels of more than 375 mg/l were recorded in 43 women before elevation of their blood pressure. Sixty-five women of 197 who remained normotensive had microproteinuria levels of more than 375 mg/l. The sensitivity and specificity of microproteinuria levels of more than 375 mg/l as a screening test for prediction of pre-eclampsia was 73% and 67%, respectively. Therefore, microproteinuria of more than 375 mg/l may be used as a cut-off value and as a screening test for the early detection of women at risk of developing pre-eclampsia. Serum uric acid and creatinine had no predictive value as a screening test for pre-eclampsia.