Original Research Article
Year: 2018 | Month: February | Volume: 8 | Issue: 2 | Pages: 41-52
Microalbuminuria Detected at Mid Term as a Marker for Adverse Pregnancy Outcome
Rachita Chawla1, Sunita Malik2
1Senior Resident, OBG, PGIMER Rohtak
2Consultant OBG, Safdarjung Hospital, New Delhi
Corresponding Author: Rachita Chawla
Background: Maternal and neonatal outcome is an index of health in society. Various markers are being searched so as to increase the well being of mother and fetus in pregnancy. Studies have shown an association between microalbuminuria and pregnancy outcome.
This study was undertaken to find out whether microalbuminuria detected at midterm could serve as marker for adverse pregnancy outcome.
Materials and Methods: A Prospective case control study was carried out. 410 people were tested of which 30 who were positive for microalbuminuria were kept in group A.
Subjects without microalbuminuria were taken as controls (GROUP B).
They were compared for pregnancy outcome.
Results: Microalbuminuria seemed to be an important marker of pregnancy outcome.
Roughly 2/3 rd women positive for microalbuminuria were picked up before 24 weeks.
Pre eclampsia was more prevalent in the microalbuminuric group with a p value<0.05.It could be concluded that patients testing positive for microalbuminuria at midterm are likely to develop pre eclampsia roughly 10 weeks after. IUGR was also significant in the microalbuminuria positive patients. (p value<0.05). Mean duration of time elapse between detection of microalbuminuria and IUGR was 10.8 weeks. Gestational diabetes mellitus was more common in the microalbuminuric patients, although not significant. It was seen roughly 10 weeks after detection. Prom was shown to have no relation with microalbuminuria. Preterm delivery was more common in positive patients. Mean birth weight was not affected by positive patients. However it was associated with lower APGAR scores and hence the higher rate of NICU admission. Induction of labour was more commonly seen in the microalbuminuria positive patients due to co morbidities mostly pre eclampsia and prom.
Conclusion: Microalbuminuria is an important prognostic marker for adverse pregnancy outcome. It can be done around the 2nd trimester end (around 20-24 weeks). It is a cheap, easily available and cost effective method of detecting many co morbidities affecting a normal pregnancy. Presence of microalbuminuria could be a warning sign of the development of pre eclampsia, gestational diabetes which could lead to pre term delivery and the presence of IUGR. Subsequently rates of NICU admission and lower apgar scores increase with such co morbidities. In the study we found out that roughly 10 weeks period was present between detection of microalbuminuria and the onset of pre eclampsia and gestational diabetes mellitus. Therefore presence of microalbuminuria warrants attention and strict blood pressure monitoring along with glycemic control to optimize the outcome of pregnancy.
Key words: Microalbuminuria, Pre Eclampsia, Preterm Labour, Intra Uterine Growth Retardation