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Relationship between urinary albumin and albumin/creatinine ratio during normal pregnancy and pre-eclampsia.
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Cell Biology.
Department of Medical Sciences. (Klinisk kemi)
Department of Women's and Children's Health.
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2004 (English)In: Scand J Clin Lab Invest, ISSN 0036-5513, Vol. 64, no 1, 17-23 p.Article in journal (Other scientific) Published
Abstract [en]

Risberg A, Larsson A, Olsson K, Lyrenäs S, Sjöquist M.

Department of Nursing and Health Sciences, Mid Sweden University, Ornsköldsvik, Sweden. anitha.risberg@mh.se

Pre-eclampsia is a serious complication of pregnancy and it is important to detect the condition as early as possible. Albuminuria is an important symptom of pre-eclampsia and repeated urine analyses to screen for the condition are part of the standard antenatal care. The purpose of this study was to investigate whether measurement of the urine albumin/creatinine ratio in spot samples could be a complement to the dipstick method and could reduce the need for 24-h urine collections. Urine samples were collected for 24 h in weeks 12, 24 and 36 of pregnancy from both normotensive women and women who developed hypertension or who had pregnancy-induced hypertension (PIH) when they entered the study. The 24-h albumin excretion was significantly correlated to the albumin/creatinine ratio in all measurements (Pearson correlation coefficient). In week 12, the values were: n = 44, r = 0.964, p < 0.001 (normotensive group) and in the PIH group: n = 8, r = 0.789, p < 0.05. In week 24, the correlation values were r = 1.0 and p < 0.001 in both the normotensive group (n = 41) and in the PIH group (n = 11). In week 36 the correlation values were r = 0.791 and p < 0.001 in the normotensive group (n = 39) and r = 1.0 and p < 0.001 in the PIH group (n = 16). Microalbuminuria was defined as urine albumin excretion higher than 30 mg/24 h and this corresponded to an albumin/creatinine ratio of 2.9. Microalbuminuria was found in three persons in the PIH group and in two persons in the normotensive group. Overt albuminuria (> 300 mg/24 h) was found in one of the 46 normotensive women (2%) and in 3 of the 19 PIH women (16%). In all these women the high albumin values had been detected by using the albumin/creatinine ratio method. In conclusion, it has been found that the albumin excretion in urine correlates significantly to the albumin/creatinine ratio during pregnancy. The urinary albumin/creatinine ratio appears to be a good alternative to the dipstick method and to 24-h urine collections.

PMID: 15025425 [PubMed - indexed for MEDLINE]

Place, publisher, year, edition, pages
2004. Vol. 64, no 1, 17-23 p.
Keyword [en]
Adult, Albuminuria/*diagnosis/urine, Blood Pressure, Creatinine/*urine, Female, Humans, Pre-Eclampsia/*diagnosis, Pregnancy
URN: urn:nbn:se:uu:diva-12865PubMedID: 15025425OAI: oai:DiVA.org:uu-12865DiVA: diva2:40635
Available from: 2008-08-01 Created: 2008-08-01 Last updated: 2011-01-12
In thesis
1. Hormones and fluid balance during pregnancy, labor and post partum
Open this publication in new window or tab >>Hormones and fluid balance during pregnancy, labor and post partum
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to determine any association between plasma oxytocin and vasopressin concentrations and renal water and sodium excretion during normal pregnancy. In addition to investigate changes in concentrations of estradiol, progesterone, oxytocin, cortisol, and glucose in the blood before and in the nearest hours after delivery and if treatment with oxytocin affected these concentrations and the fluid balance during the different stages of labour.

Oxytocin, vasopressin, estradiol, progesterone, and cortisol were analysed in blood plasma or serum by radioimmunoassay or ELISA: serum glucose, and osmolality, and sodium in plasma and urine were  analysed by standard laboratory techniques.

Fifty-seven women were studied during pregnancy and fifty-one during parturition and post partum. The low plasma vasopressin and increasing plasma oxytocin concentrations with unchanged water and sodium excretion indicate that oxytocin assists vasopressin in concentrating urine during pregnancy.

Plasma vasopressin concentration continued to be low during parturition and post partum. Urine flow and concentration was unrelated to changes in plasma sodium concentration, indicating regulation of fluid balance during parturition was different to the non-gravid state. Women with weak myometrial contractions during parturition (slow progress of labour) reacted differently than women with normal parturition and a group of women with fast progress of labour. The group with slow labour had lower serum estradiol concentration in the latency phase and became hyponatremic. Pulsatile and continuous oxytocin infusions were both effective in the treatment of slow progress of labour. A lower amount of oxytocin was needed to affect delivery when given as pulsatile infusion.

Serum cortisol and glucose concentrations were high during labour and cortisol level remained elevated after delivery and glucose concentration reached the highest levels (12 mmol/L) at the same time. Insulin resistance together with the long time of elevated cortisol concentration partly explained the high glucose concentration. In conclusion, fluid balance is not regulated according to the usual sensitive osmotic and volumetric influence on vasopressin release from the neurohypophysis during pregnancy and parturition. Parturition involves a change from one demanding condition, pregnancy, to another, lactation. Parturition and the hours directly after delivery are a turbulent period involving considerable stress.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 54 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 478
cortisol, estradiol, glucose, labour, osmolality, oxytocin, parturition, pregnancy, pregnancy-induced hypertension, progesterone, vasopressin
National Category
Medical and Health Sciences
Research subject
urn:nbn:se:uu:diva-107811 (URN)978-91-554-7597-0 (ISBN)
Public defence
2009-10-02, B22, Biomedicinskt centrum, Uppsala, 13:15 (Swedish)
Available from: 2009-09-11 Created: 2009-08-30 Last updated: 2009-09-11Bibliographically approved

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