MICROALBUMINURIA ANALYSIS AND PREGNANCY - AN APPROACH TO DETECT PLACENTARY INSUFFICIENCY

Objective: To assess the value of micro-albuminuria analysis (MA) in p redicting clinical complications of placentary insufficiency in women with no known risk factor. Study design: A blind prospective investiga tion 20-24 weeks into pregnancy in a nulliparous population with no kn own risk factor. A reactive strip with a positive threshold value of 1 0 mg/l is used to detect MA. Judgment criteria concerning the progress of pregnancy are based on blood pressure during the 8th and 9th month of pregnancy and on the 2nd day after delivery, on albuminuria analys is in the 8th and 9th month of pregnancy and by the existence of fetal hypotrophia at birth. Results: Some 218 patients participated in the investigation. MA was positive in 62 cases (28.4%). Of the 197 births which occurred 54 (27.4%) cases of positive MA, 34 (17.2%) cases prese nted positive judgment criteria indicating placentary insufficiency. T he 21 others pregnancies are in course. MA sensitivity was thus 79.4% and specificity 83.4%. Negative predictive value (NPV) was 95.1% and p ositive predictive value (PPV) 50%. Conclusion: Our test is a reliable , simple and easily reproducible indicator of micro-albuminuria. In co mparison with other tests it gives a good detection rate of a risk gro up for complication of placentary insufficiency. NPV is excellent, vir tually excluding the occurrence of excessive blood pressure or intra-u terine growth retardation. PPV is less good.