Evaluation of some diagnostic tests (Plasma Fibronectin, urinary calcium/ creatinin ratio and roll-over test) in early prediction of pregnancy induced hypertension

51 SUMMARY Early prediction of preeclampsia has recently been gaining an increasing popularity, since development of this syndrome would be prevented if a highly sensitive diagnostic test could be verified Many tests have been suggested for early prediction. In present study, three of these tests; plasma fibronectin concentrations, urinary calcium / creatinin ratio and roll-over test have been investigated The study group included 121 normotensive pregnant women without chronic hypertension or systemic disease. Of these patients, 94 remained normotensive, while 20 developed transient hypertension and 7 preeclampsia during the follow-up (till the second day after delivery). We could not find out any convincing evidence that urinary calcium/ creatinin ratio has been beneficial for early prediction of this disease. There was a significant relation between positive roll-over test and gestational hypertension (p<0, 05), but sensitivity of the test wasn 't satisfactory (% 25 and %40for transient hypertension and preeclampsia respectively) for therapeutic interventions. Fibronectin, based on the cut off value of 450 mg/l which has been calculated for our study group was a good predictor of preeclampsia with a sensivity of 86% and a specificity of 89%. However sensitivity of the test for transient hypertension was found to be quite unpredictive (%4). Another finding, extracted from our data was that fibronectin concentrations inversely correlated with birth weight. It seems that fibronectin can also be used for early diagnosis of intrauterine growth retardation.