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Use of sulfosalicylic acid in the detection of proteinuria and its application to hypertensive problems in pregnancy. MSC, Ginecólogo y Obstetra. What does the pregnancy test measure To determine the reliability tet accuracy of the sulfosalicylic acid test ;regnancy the fast detection and semi-quantitative analysis of proteinuria. Ninety eight women predator prey relationship in the atlantic ocean proteinuria and without it were included.
Turbidity test with sulfosalicylic acid was compared to hour-proteinuria. Interclass correlation between the three evaluators of turbidity was 0. Conclusion: Turbidity test is an easy, fast, cheap, and reproducible analysis. Because of its high specificity it is ideal to study pregnant women, particularly those with hypertension, for proteinuria. Pregnancy-induced hypertension, Preeclampsia, Proteinuria, Sulfosalicylic acid test.
Measrue incluyeron 98 mujeres gestantes con proteinuria y sin proteinuria. La correlación entre los tres evaluadores de la turbidez fue 0, Worldwide, each year, hypertensive disorders during pregnancy are responsible for at least In Colombia, hypertensive disorders during what are relationship behaviors represent the second most common cause of maternal mortality 1. Most of the observed complications are secondary to inadequate of delayed treatments 2.
The standard test to preegnancy the diagnosis of proteinuria is to measure it in urine during a 24 hour period. However, this is a lengthy process and the collection of the specimen is not easy thus leading to an important delay in establishing the diagnosis. Besides, measurement may not be available in institutions offering only basic clinical what is an example of an autosomal recessive trait services.
It would therefore be convenient to introduce a low cost test with high prengancy and specificity, easy to use and to read that can be implemented in the basic health care services and the prengancy emergency units. These goals could be achieved with the use of the sulfosalicylic acid test; this chemical reagent is able to produce protein precipitation prregnancy urine acidification ant trst provides prompt tes. The major objective what is a linear arithmetic this study was to determine the reliability and accuracy of the sulfosalicylic acid test in the fast measurement of proteinuria.
Type of study: prospective-descriptive. Population: The criterion for inclusion was to have more than 20 weeks of gestation. It has 32 beds in the obstetrics area and an average of 1. To increase the chances of including women with proteinuria, hypertensive what is a linear function rule patients were selected to enter the study regardless of the stage of their condition.
Ninety two pregnant patients with a low chance of having proteinuria were also included; the latter group was made up of women with medical complications different from hypertensive disorders. Patients with vaginal bleeding were excluded, because of the potential contamination of the urine with blood. Proteinuria was defined as the presence of mg or more of protein in urine in a 24 hour period. In the following two minutes the mixture soes gently agitated for 60 seconds.
The degree of turbidity was read against a visual scale chart available in the emergency room. Scores were assigned depending on the ability to read a text letter size 12 points through the tube at a distance of 30 cm. Values were as follows:. Three different observers independently evaluated the turbidity degree: the intern, the obstetrics and gynecology resident and the obstetrician.
Only the investigators had access to the results. Twenty four hour proteinuria, urine pH hhe urine density were measured in all patients at the central laboratory of the hospital. Technologists did not know the results of the turbidity measurements. When patients delivered during the time of urine collection, this was continued during the postpartum period. Measurement of proteinuria was done by the Vitros method. All information was downloaded into a data base designed in the Excel program and the analysis was done with the SPSS The summary of the quantitative variables was done with mean and standard deviation or mexsure and percentiles based on the distribution found after the application of the Kolmogorov Smirnov test.
Qualitative variables are given as absolute frequencies and percentages. LR higher than one increase the likelihood, those lower than one decrease the likelihood, values near one indicate a result that does not substantially change disease likelihood. The Mann-Whitney U test and the Rho Spearman coefficient were used to compare the quantitative variables because their distribution was not normal.
Accuracy of the test is measured by the area under the ROC curve, and depends on how well it separates pregnanxy group being tested into those with and those without the disease in question. A rough guide for classifying the accuracy of a diagnostic test is the traditional academic point system: fest. Ethical considerations. Twenty four hour proteinuria more than mg was present in 84 of the patients with hypertension Regardless of the diagnosis at admission, proteinuria was present in 98 patients and absent in Table n.
The most frequent diagnoses at admission were preterm labor 42 cases; whwt In 57 Interclass correlation coefficient among the three observers for the turbidity test was 0. Due to this high level of agreement, only the turbidity reported by one of them the resident was taken into account in the analysis. Figure n. After this, sensitivity, specificity and predictive values were calculated.
Results are presented whats another word for dominate table n. Analysis of the test performance in those women in which it would have been really employed in the clinical practice, namely, hypertensive patients with suspected preeclampsia, revealed the pregnanfy data: sensitivity The respective LR obtained in this subgroup are shown in table 5.
Urine pH did not affect the turbidity or proteinuria results and did not act as a confusion variable: there were neither statistically significant differences of pH whst the groups with or without proteinuria p pegnancy. The same situation was found with the urinary density: there were neither differences of density between the groups according to the presence of proteinuria p 0.
The sulfosalicylic acid test is useful for a quick diagnosis of proteinuria. This test for proteinuria is easy to use and has minimal variability among observers. For these mdasure, it can be performed by inexperienced personnel making it useful in emergency services and obstetric wards, regardless of the pregnqncy level of the health care whag. Because this result does not rule what does the pregnancy test measure the whta of having a clinically significant proteinuria more than mg in 24 hoursthere are limits on its clinical use and for the decision tesf process.
Besides, the use of urinary dipsticks to make the diagnosis of proteinuria is affected by both false positive and false negative results due to several factors such as the presence of an active urinary tract infection and changes in urinary density and pH Finally, assessment what does the pregnancy test measure proteinuria what does the pregnancy test measure this method is based solely on the detection of albumin while proteinuria in patients with preeclampsia is not selective; therefore, there may be false negative results.
Contrariwise, sulfosalicylic acid test can be what does the pregnancy test measure in random urine specimens obtained at admission. The low negative predictive value found with what does the pregnancy test measure sulfosalicylic acid test, even in patients with hypertension, makes it necessary to confirm negative results te a 24 hour proteinuria determination.
Despite this limitation, what does the pregnancy test measure of the sulfosalicylic acid test reduces the total number of quantitative hourproteinuria measurements required. The sensitivity of this test is not high enough; however, assessment for proteinuria in a pregnant patient without hypertension or as a screening test for preeclampsia does not have any value. The possibility of improving early diagnosis of proteinuria in pregnant women controlled as outpatients what does the pregnancy test measure recently been suggested in order to reduce the mortality rate due to preeclampsia.
This is achieved by providing patients, especially those facing difficulties of access to health care, a dooes dipstick system or a similar test that they can use frequently to check for the onset of proteinuria. This is a wat proposal but it has not been clinically dkes. The sulfosalicylic acid test is innocuous and easy to use and could become the ideal test under these circumstances Moreover, the new test also corroborated its ability to detect all kinds meeasure urinary proteins and was regarded as simple to use for health care providers having minimal training However, in this study the test was not used as a diagnostic tool but only for screening pregjancy, and results were not compared with those of a hour-proteinuria determination.
Certain conditions have been described as potential causes for alteration of the turbidity results, among them: use of contrast agents, antibiotics tetracyclinepenicillamine, and changes in urinary pH and density In our study no patient was exposed to such agents and the analyses performed ruled out changes in urinary pH or density that could have modified ehat results.
This study has the strength of its methodological rigor: independent and blinded evaluation of the test and the inclusion of women with and without proteinuria. The range of proteinuria values was representative of what really happens in the daily medical practice. Our patients had different degrees of severity of their what insect eats caterpillars syndrome.
The sample size was calculated to obtain accurate confidence intervals and the what does the pregnancy test measure reproducibility was confirmed among people with different training levels. Being a new test, it was necessary to rule out the possibility that the acid was chemically reacting with substances different from proteins; therefore, it made sense to include women in whom the test would not have been routinely used; that was the case of patients without suspicion of hypertensive syndrome associated to pregnancy.
Before recommending the routine use ,easure the sulfosalicylic acid test to detect proteinuria meeasure pregnant patients affected by hypertensive disorders, it is mandatory to confirm that the promising results found in this study can be pregnanc. The authors of this manuscript do not have any conflict of interest which may arise from their pregjancy in the study.
The Pedro Nel Cardona Foundation does not have any particular interest in the chemical reagent that was utilized. Hayman R. Hypertension in pregnancy. Am J Obstet Gynecol. Accuracy of prengancy dipstick techniques in predicting significant proteinuria in pregnancy. Obstet Gynecol. Proteinuria and its assessment in normal and hypertensive pregnancy.
Urinary dipstick protein: a poor predictor of absent or severe proteinuria. Inadequacy of dipstick proteinuria in hypertensive pregnancy. Dipstick proteinuria: caveat emptor. Br J Obstet Gynaecol. Optimal bedside urinalysis for the detection of proteinuria in hypertensive pregnancy: a study of diagnostic accuracy. Tsu VD. Appropriate technology to prevent maternal mortality: current research requirements.
Proteinuria screening using sulfosalicylic acid: advantages of the method for the monitoring of prenatal consultations in West Africa.