Assessment of dipstick sensitivity and specificity for screening of hypertensive pregnancies

Detalhes bibliográficos
Autor(a) principal: Sabino da Cunha Filho, João
Data de Publicação: 2022
Outros Autores: Vettorazzi-Stuczynski, Janete, Terres, Letícia, Ferronato, Maria Emilia, Vetori, Daniela, L. Ramos, José Geraldo, Martins-Costa, Sérgio
Tipo de documento: Artigo
Idioma: por
Título da fonte: Clinical and Biomedical Research
Texto Completo: https://seer.ufrgs.br/index.php/hcpa/article/view/125338
Resumo: OBJECTIVE: Hypertensive disorders during pregnancy are a significant cause of maternal, fetal, and neonatal morbimortality; hence the need for an accurate and simple diagnostic method for situations of obstetrical emergencies. The dipstick is widely used as method for the detection of protein in urine. The objective of our study is to compare dipstick results obtained from urinary samples with the results of 24-h proteinuria tests, which is considered the gold standard for detection of urinary protein.MATERIALS AND METHODS: We carried out a retrospective study with medical records of patients admitted to the Obstetrics Center of the Hospital de Clínicas in 1998 due to increase in blood pressure. Statistical analysis of data was carried out using the c2 test. This study was approved by the Ethics and Research Committee of the Hospital de Clínicas.RESULTS: 175 medical records of patients who presented hypertensive disorder were retrospectively studied. Our population presented an age average of 28 years, 34% of mothers were primiparas and 54% presented a gestational age of less than 36 weeks. As to the final diagnosis, 21% showed mild preeclampsia, 20.4% severe preeclampsia, 9.2% preeclampsia over essential hypertension, 37% transient hypertension, and 10% chronic systemic hypertension. Comparison of dipstick test to 24-h proteinuria exam indicated dipstick sensitivity of 78%, specificity of 64%, positive predictive value of 59%, and negative predictive value of 81%.CONCLUSIONS: Our results suggest that dipstick should not be used as the sole method for screening preeclampsia and that, in obstetrical emergencies, clinical presentation of the patient should be given priority over the dipstick. Other methods of screening of proteinuria should also be assessed with the objective of reducing falsenegative results. 
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spelling Assessment of dipstick sensitivity and specificity for screening of hypertensive pregnanciesAvaliação da sensibilidade e especificidade do dipstick como teste de rastreamento para doença hipertensiva induzida pela gestaçãoPré-eclampsiagestaçãoproteinúriateste de fita reagente na urinaPregnancyproteinuriaurinary dipstick proteinhypertensionOBJECTIVE: Hypertensive disorders during pregnancy are a significant cause of maternal, fetal, and neonatal morbimortality; hence the need for an accurate and simple diagnostic method for situations of obstetrical emergencies. The dipstick is widely used as method for the detection of protein in urine. The objective of our study is to compare dipstick results obtained from urinary samples with the results of 24-h proteinuria tests, which is considered the gold standard for detection of urinary protein.MATERIALS AND METHODS: We carried out a retrospective study with medical records of patients admitted to the Obstetrics Center of the Hospital de Clínicas in 1998 due to increase in blood pressure. Statistical analysis of data was carried out using the c2 test. This study was approved by the Ethics and Research Committee of the Hospital de Clínicas.RESULTS: 175 medical records of patients who presented hypertensive disorder were retrospectively studied. Our population presented an age average of 28 years, 34% of mothers were primiparas and 54% presented a gestational age of less than 36 weeks. As to the final diagnosis, 21% showed mild preeclampsia, 20.4% severe preeclampsia, 9.2% preeclampsia over essential hypertension, 37% transient hypertension, and 10% chronic systemic hypertension. Comparison of dipstick test to 24-h proteinuria exam indicated dipstick sensitivity of 78%, specificity of 64%, positive predictive value of 59%, and negative predictive value of 81%.CONCLUSIONS: Our results suggest that dipstick should not be used as the sole method for screening preeclampsia and that, in obstetrical emergencies, clinical presentation of the patient should be given priority over the dipstick. Other methods of screening of proteinuria should also be assessed with the objective of reducing falsenegative results. OBJETIVO: Os distúrbios hipertensivos da gestação são importante fator causal de morbimortalidade materna, fetal e neonatal. É inquestionável a necessidade de um diagnóstico preciso e simplificado para uso em emergência obstétrica. O uso de fita reagente de imersão em urina (dipstick) é utilizado amplamente como método de detecção de proteína na urina. Este estudo tem como objetivo principal comparar os resultados do dipstick em amostra urinária ao resultado da proteinúria de 24 horas que é considerado o teste padrão-ouro na detecção de proteínas na urina. MATERIAIS E MÉTODOS: Realizamos um estudo retrospectivo dos prontuários das pacientes que internaram no centro obstétrico do Hospital de Clínicas de Porto Alegre no ano de 1998 com algum distúrbio hipertensivo na gestação. Na análise dos dados, utilizou-se o teste c2. Este estudo foi aprovado pela Comissão de Ética em Pesquisa do Hospital de Clínicas de Porto Alegre. RESULTADOS: Foram analisados 175 prontuários de pacientes com algum distúrbio hipertensivo, com idade média de 28 anos. Trinta e quatro por cento eram primigestas e 54% apresentavam idade gestacional inferior a 36 semanas. Quanto ao diagnóstico definitivo, 21% apresentaram pré-eclampsia leve, 20,4% pré-clampsia grave, 9,2% pré-eclampsia sobreposta, 37% hipertensão transitória e 10% hipertensão arterial sistêmica crônica. A sensibilidade do dipstick, quando comparado à proteinúria de 24 horas maior que 300 mg, foi de 78%; a especificidade, de 64%; o valor preditivo positivo, de 59%, e negativo, de 81%.  CONCLUSÕES: Esses resultados nos levam a concluir que este teste deve ser visto com restrições como único teste de rastreamento da pré-eclampsia (PE) e que nas emergências obstétricas devemos dar prioridade à apresentação clínica da paciente. Outros métodos de rastreamento de proteinúria devem ser avaliados, com o objetivo de diminuir o número de falso-negativo. HCPA/FAMED/UFRGS2022-06-21info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionPeer-reviewed ArticleAvaliado por Paresapplication/pdfhttps://seer.ufrgs.br/index.php/hcpa/article/view/125338Clinical & Biomedical Research; Vol. 20 No. 2 (2000): Revista HCPAClinical and Biomedical Research; v. 20 n. 2 (2000): Revista HCPA2357-9730reponame:Clinical and Biomedical Researchinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSporhttps://seer.ufrgs.br/index.php/hcpa/article/view/125338/85219http://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessSabino da Cunha Filho, João Vettorazzi-Stuczynski, Janete Terres, Letícia Ferronato, Maria Emilia Vetori, Daniela L. Ramos, José Geraldo Martins-Costa, Sérgio 2022-09-16T16:33:08Zoai:seer.ufrgs.br:article/125338Revistahttps://www.seer.ufrgs.br/index.php/hcpaPUBhttps://seer.ufrgs.br/index.php/hcpa/oai||cbr@hcpa.edu.br2357-97302357-9730opendoar:2022-09-16T16:33:08Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)false
dc.title.none.fl_str_mv Assessment of dipstick sensitivity and specificity for screening of hypertensive pregnancies
Avaliação da sensibilidade e especificidade do dipstick como teste de rastreamento para doença hipertensiva induzida pela gestação
title Assessment of dipstick sensitivity and specificity for screening of hypertensive pregnancies
spellingShingle Assessment of dipstick sensitivity and specificity for screening of hypertensive pregnancies
Sabino da Cunha Filho, João
Pré-eclampsia
gestação
proteinúria
teste de fita reagente na urina
Pregnancy
proteinuria
urinary dipstick protein
hypertension
title_short Assessment of dipstick sensitivity and specificity for screening of hypertensive pregnancies
title_full Assessment of dipstick sensitivity and specificity for screening of hypertensive pregnancies
title_fullStr Assessment of dipstick sensitivity and specificity for screening of hypertensive pregnancies
title_full_unstemmed Assessment of dipstick sensitivity and specificity for screening of hypertensive pregnancies
title_sort Assessment of dipstick sensitivity and specificity for screening of hypertensive pregnancies
author Sabino da Cunha Filho, João
author_facet Sabino da Cunha Filho, João
Vettorazzi-Stuczynski, Janete
Terres, Letícia
Ferronato, Maria Emilia
Vetori, Daniela
L. Ramos, José Geraldo
Martins-Costa, Sérgio
author_role author
author2 Vettorazzi-Stuczynski, Janete
Terres, Letícia
Ferronato, Maria Emilia
Vetori, Daniela
L. Ramos, José Geraldo
Martins-Costa, Sérgio
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Sabino da Cunha Filho, João
Vettorazzi-Stuczynski, Janete
Terres, Letícia
Ferronato, Maria Emilia
Vetori, Daniela
L. Ramos, José Geraldo
Martins-Costa, Sérgio
dc.subject.por.fl_str_mv Pré-eclampsia
gestação
proteinúria
teste de fita reagente na urina
Pregnancy
proteinuria
urinary dipstick protein
hypertension
topic Pré-eclampsia
gestação
proteinúria
teste de fita reagente na urina
Pregnancy
proteinuria
urinary dipstick protein
hypertension
description OBJECTIVE: Hypertensive disorders during pregnancy are a significant cause of maternal, fetal, and neonatal morbimortality; hence the need for an accurate and simple diagnostic method for situations of obstetrical emergencies. The dipstick is widely used as method for the detection of protein in urine. The objective of our study is to compare dipstick results obtained from urinary samples with the results of 24-h proteinuria tests, which is considered the gold standard for detection of urinary protein.MATERIALS AND METHODS: We carried out a retrospective study with medical records of patients admitted to the Obstetrics Center of the Hospital de Clínicas in 1998 due to increase in blood pressure. Statistical analysis of data was carried out using the c2 test. This study was approved by the Ethics and Research Committee of the Hospital de Clínicas.RESULTS: 175 medical records of patients who presented hypertensive disorder were retrospectively studied. Our population presented an age average of 28 years, 34% of mothers were primiparas and 54% presented a gestational age of less than 36 weeks. As to the final diagnosis, 21% showed mild preeclampsia, 20.4% severe preeclampsia, 9.2% preeclampsia over essential hypertension, 37% transient hypertension, and 10% chronic systemic hypertension. Comparison of dipstick test to 24-h proteinuria exam indicated dipstick sensitivity of 78%, specificity of 64%, positive predictive value of 59%, and negative predictive value of 81%.CONCLUSIONS: Our results suggest that dipstick should not be used as the sole method for screening preeclampsia and that, in obstetrical emergencies, clinical presentation of the patient should be given priority over the dipstick. Other methods of screening of proteinuria should also be assessed with the objective of reducing falsenegative results. 
publishDate 2022
dc.date.none.fl_str_mv 2022-06-21
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Peer-reviewed Article
Avaliado por Pares
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://seer.ufrgs.br/index.php/hcpa/article/view/125338
url https://seer.ufrgs.br/index.php/hcpa/article/view/125338
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://seer.ufrgs.br/index.php/hcpa/article/view/125338/85219
dc.rights.driver.fl_str_mv http://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv HCPA/FAMED/UFRGS
publisher.none.fl_str_mv HCPA/FAMED/UFRGS
dc.source.none.fl_str_mv Clinical & Biomedical Research; Vol. 20 No. 2 (2000): Revista HCPA
Clinical and Biomedical Research; v. 20 n. 2 (2000): Revista HCPA
2357-9730
reponame:Clinical and Biomedical Research
instname:Universidade Federal do Rio Grande do Sul (UFRGS)
instacron:UFRGS
instname_str Universidade Federal do Rio Grande do Sul (UFRGS)
instacron_str UFRGS
institution UFRGS
reponame_str Clinical and Biomedical Research
collection Clinical and Biomedical Research
repository.name.fl_str_mv Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)
repository.mail.fl_str_mv ||cbr@hcpa.edu.br
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