Validating the Diagnostic Accuracy of Dipstick Urine Analysis in Single Voided Urine by using 24 Hours Collection as Gold Standard for Diagnosis of Proteinuria in Patients with Pregnancy Induced Hypertension
Objectives: To evaluate the diagnostic accuracy of dipstick urine analysis in single voided urine by using 24 hours collection as gold standard for diagnosis of proteinuria in patients with pregnancy induced hypertension.
Methodology: This cross sectional study was conducted at department of Obstetrics and Gynecology, Jinnah Hospital, Unit-I, Lahore from 26-01-2016 to 25-07-2016. A total of 355 pregnant women were included in this study. Details of each subject’s urinary protein was assessed by urine dipstick in single voided urine as well as in 24 hours urinary collection (gm/24 hours) was sent to laboratory for analysis.
Results: Mean age of the patients was 24.5±8.5 years. Out of 355 patients, positive proteinuria on dipstick was observed in 176 (49.6%). Comparison of urine dipstick in the diagnosis of proteinuria in PIH patients by taking 24 hours collection as gold standard shows true positive cases 166, false positive 10, false negative 102 and true negative were 77. In the diagnosis of proteinuria in PIH patients urine dipstick sensitivity was 61.9%, specificity 88.5%, diagnostic accuracy 68.4%, Positive predictive value 94.3% and Negative predictive value 43.0%.
Conclusion: Accepting >2 + dipstick proteinuria improves overall diagnostic accuracy for preeclampsia at the expense of a higher false negative rate. This study emphasizes the need to confirm dipstick proteinuria with a further test such as a spot urine protein/creatinine ratio in all hypertensive pregnant women, particularly in research studies.
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