20. then effect on pregnancy outcomes of pregnancy week emerging from isolated proteinuria

Objective: Preeclampsia is a serious obstetrical disoder causing significant mortality and morbidity on pregnant and fetus. Proteinuria is a component of preeclampsia. Proteinuria without presence of preeclampsia can be a precursor of preeclampsia. In this study we aimed to investigate the relation of isolated proteinuria with the outcome of gestation both at neonate and the mother, as well as investigation of the effect of presence of proteinuria at 24-hour urine collection after 20th gestational age on development of preeclampsia. Materials and Methods: 118 pregnant women more than 20 weeks of gestation, admitted to O&G cliinic at BEU hospital between March 2014 and March 2015 for routine antenatal care were recruited in the study. Exclusion criteria were defined as: known renal and autoimmune diseases, chronic hypertension, pregestational diabetes and urinary tract infections, multiple pregnancies and history of intrauterine fetal death. Patients were divided into two gropus as patients with isolated proteinuria and without isolated proteinuria. Demographics, presence of gestational diabetes, presence and beginning of preeclampsia and proteinuria were questioned. Routine complete blood analysis, routine biochemistry tests and biochemical analysis of 24 hours urine were collected. The patients were followed until delivery. Presence and progress to preeclampsia rates and maternal and perinatal outcomes between groups were analysed. Findings: Out of 118 patients included in the study, 58 patients demonstrated isolated proteinuria and whereas remainder 60 patients did not demonstrate proteinuria. No difference was observed between groups regarding age, parity and week of 24-h urine collection (p>0.05). 13 % of all patients developed preeclampsia. 20.6% of preeclamptic patients had proteinuria previously (p<0.05). No significant difference were observed between proteinuric and non-proteinuric patients regarding birth-weight, Apgar score, week of delivery, neonatal intensive care unit (NICU) requirement and NICU stay length. Likewise regarding maternal outcomes, no significant difference could be demonstrated regarding type of delivery and maternal outcomes. Also biochemical markers such as AST, ALT, LDH, creatinin and platelet-count were also similar between groups (p>0.05). Result: In this study, isolated proteinuria was found to be correlated with increased risk of preeclampsia. Gestational screening of pregnant for proteinuria by 24-h urine sampling may be useful for early detection of preeclampsia and detection of patient with increased risk. Further studies with increased number of cases were warranted for development of treatment and follow-up modalities.