Application of urinary protein and umbilical artery blood flow monitoring in gestational hypertension

Objective To evaluate the application of urinary microalbumin/creatinine, 24 h proteinuria and umbilical artery blood flow monitoring in gestational hypertension. Methods Totally 193 patients with gestational hypertension who were admitted into Department of Nephropathy, the Third People's Hospital of Yunnan Province from March 2014 to December 2017 were selected. They were divided into three groups according to their conditions: a gestational hypertension group (Group I, n=65), a mild preeclampsia group (GroupⅡ, n=62) and a severe preeclampsia group (Group Ⅲ, n=66). Meanwhile, another 60 healthy pregnant women were selected as a control group. Then, urinary samples were collected. The urinary microalbumin and creatinine levels were detected by ELISA, and their ratio was calculated. The amount of 24 h proteinuria was detected by the pyrogallol red molybdate complex method. The peak systolic velocity/end diastolic velocity (S/D) and resistance index (RI) of umbilical artery were detected with doppler ultrasound. Furthermore, gestational outcomes were recorded to analyze the value of each indicator to predict adverse gestational outcomes. Results The ratio of urinary microalbumin/creatinine, 24 h proteinuria and umbilical artery S/D and RI were all increased in the control group, and GroupsⅠ, Ⅱ and Ⅲ, with statistical differences between each groups (P<0.05). Group Ⅱ presented higher incidences of fetal intrauterine distress, premature delivery and total adverse pregnant outcome than GroupⅠand the control group, while higher incidences were found in placental abruption, postpartum hemorrhage, fetal intrauterine distress, hypoxic-ischemic encephalopathy, premature delivery and total adverse pregnancy outcome in Group Ⅲ, compared with those in GroupⅠ and the control group (P<0.05). According to the ROC curve, the ratio of urinary microalbumin/creatinine, 24 h proteinuria and umbilical artery S/D and RI can well predict adverse pregnant outcome, with AUC of 0.823, 0.734, 0.813 and 0.776. Conclusions The ratio of urinary microalbumin/creatinine, 24 h proteinuria and umbilical artery S/D and RI can predict adverse pregnant outcome.