Measurement of proteinuria
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In pregnancy, there is a focus on measurement of proteinuria as it has been regarded as critical to the diagnosis of pre-eclampsia, the most dangerous of the hypertensive disorders of pregnancy. However, it is increasingly recognised that proteinuria is not essential for the diagnosis of pre-eclampsia, which can be based on other end-organ complications (such as elevated liver enzymes). Although heavy proteinuria has been linked with an increased risk of stillbirth in a ‘signs and symptoms only’ model of maternal risk (i.e., miniPIERS), we lack the ability to identify a level of proteinuria above which maternal and/or perinatal risk is heightened. Therefore, at present, we rely on the detection of proteinuria that exceeds what is normally excreted by healthy pregnant women. Proteinuria detection methods are also a matter of keen debate, with all available methods having advantages and disadvantages.
Côté , A-M , Mallapur , A , Katageri , G , Ramdurg , U , Bannale , S , Wang , L , Magee , L A , Miller , S & Stones , W 2016 , Measurement of proteinuria . in L A Magee , P von Dadelszen , W Stones & M Mathai (eds) , The FIGO Textbook of Pregnancy Hypertension : An evidence-based guide to monitoring, prevention and management . The Global Library of Women’s Medicine , London , pp. 19-32 .
The FIGO Textbook of Pregnancy Hypertension
Copyright © 2016 The Foundation for the Global Library of Women’s Medicine. Deposited here by kind permission of the publisher.