Objective: To evaluate the diagnostic accuracy of the first 4-hour urinary protein - creatinine ratio for prediction of the significant proteinuria in preeclampsia
Study design: Diagnostic test
Subjects: One hundred and sixty-four pregnant women who were initially diagnosed with hypertensive disorder and hospitalized in the obstetric ward and labor room at Bangkok Metropolitan Administration Medical Collage and Vajira Hospital between July 2005 and April 2006.
Material and Method: Urine samples were collected within 24 hours in two consecutive periods: the first 4 hours and the next 20 hours. The urine volume, urine protein and creatinine concentration were separately measured and the first 4-hour urinary protein - creatinine ratio were calculated. With the use of a protein level > 300 mg in 24 hours urine collection as the gold standard, the sensitivity and specificity of the first 4-hour urinary protein-creatinine ratio for diagnosis of significant proteinuria were determined with cutoffs range.
Results: One hundred and sixty four patients were recruited for this study including 112 patients (68.3%) who had preeclampsia. The first 4-hour urinary protein-creatinine ratio was most accurate for diagnosis of preeclampsia is 0.30 with 81% sensitivity, 88% specificity, PPV of 93%, and NPV of 71%.
Conclusion: The first 4-hour urinary protein-creatinine ratio at 0.3 is the most accurate value for diagnosis of significant proteinuria in preeclampsia

Keywords: First 4-Hour urinary protein-creatinine ratio, Significant proteinuria, Preeclampsia