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Urinary albumin excretion in pregnancy
British Journal of Obstetrics and Gynaecology
|February 1, 1986
Summary
Sensitive assays reveal that proteinuric pre-eclampsia does not show increased urinary albumin loss before diagnosis. Mild pre-eclampsia and chronic hypertension groups had normal albumin excretion antenatally.
Area of Science:
- Obstetrics and Gynecology
- Nephrology
- Clinical Chemistry
Background:
- Urinary albumin excretion is a marker for renal health in pregnancy.
- Conventional methods for detecting proteinuria in pre-eclampsia may lack sensitivity.
Purpose of the Study:
- To investigate urinary albumin excretion in pregnant women using a sensitive radioimmunoassay.
- To determine if increased albumin loss precedes clinical diagnosis of pre-eclampsia.
Main Methods:
- Serial urinary albumin excretion measurements via radioimmunoassay in 100 high-risk and 14 normal pregnant women.
- Categorization of participants into normal pregnancy, mild pre-eclampsia, chronic hypertension, and severe pre-eclampsia groups.
Main Results:
- Normal pregnancies showed a slight, sustained rise in albumin excretion in the third trimester and postpartum.
- Mild pre-eclampsia and chronic hypertension groups had normal antenatal albumin excretion, with a transient postpartum increase.
- Severe pre-eclampsia cases demonstrated rapid increases in albumin excretion, often preceded by elevated uric acid and decreased platelets.
Conclusions:
- Proteinuric pre-eclampsia, as detected by routine tests, is not preceded by a detectable phase of increased albumin loss.
- Sensitive assays for urinary albumin excretion may offer earlier insights into renal changes during pregnancy complications.