Background: Proteinuria is a major component of preeclampsia. Urine protein measurement after 24-hour urine collection is the traditional standard method for the detection of proteinuria. It is timeconsuming. As an alternative, random spot sampling for a urine protein to creatinine (P/C) ratio has been investigated. Aims: The aim of the study was to determine the diagnostic accuracy of the protein to creatinine ratio (P/C) compared with 24-hour urine collection for the detection of remarkable proteinuria and to evaluate the P/C ratio for different proteinuria ranges in patients with preeclampsia. Study Design: Case-control study. Methods: Two hundred and eleven pregnant women who met the criteria of preeclampsia comprised the study group and fifty three pregnant women were taken as the control group. Spot urine specimens for measuring P/C ratio were obtained taken immediately before 24-hour urine collection. The correlation between the P/C ratio in the spot urine samples and urinary protein excretion in the 24-hour collections was examined using the Spearman correlation test. Results: It was found a good positive correlation between the P/C ratio and 24-hour protein excretion, with a correlation coefficient (r) of 0.758. The best cut-off which gave the maximum area under the curve was 0.45 for 300 mg, 0.9 for 1000 mg, 1.16 for 2000 mg, 1.49 for 3000 mg, 2.28 for 4000 mg and 2.63 for 5000 mg per 24h. A P/C ratio above 0.9 strongly predicts significant proteinuria for more than 1 gram (AUC 0.97, 95% CI: 0.94-0.99 and sensitivity, specificity, positive and negative predictive value of 91%, 95.4%, 95.2%, and 91.2%, respectively). Conclusion:The P/C ratio can be used as a screening test as a good predictor for remarkable proteinuria. The P/C ratio seems to be highly predictive for diagnosis to detect proteinuria over one gram and it could be used as a rapid alternative test in preeclamptic patients not to delay implementation treatment. Keywords: Preeclampsia, proteinuria, urine proteincreatinine ratio : 27.05.2014 Accepted: 26.11.2014 • DOI: 10.5152/balkanmedj.2015 Increased rate of maternal and fetal mortality and morbidity(1, 2) is associated with preeclampsia. Proteinuria is a main component of preeclampsia and one of the diagnostic criteria of its severity. Protein measurement in the 24-hour urine sample is the traditional standard method for the detection of proteinuria (3). Twenty-four-hour urine collection is timeconsuming and inconvenient, and results may be inaccurate when the collection of urine is missed, depending upon the individual. The management of patients may be delayed during the urine collection. A more rapid test that enables the accurate

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An initial fertility conserving surgical procedure is an option in patients with extensive invasive placentation with lesser transfusion requirement and shorter operative time compared to cesarean hysterectomy.

Objective: To evaluate maternal-neonatal results in women who underwent vaginal birth after cesarean (VBAC) and elective repeat cesarean delivery (ERCD). Material and methods: In a two-year retrospective cohort analysis, 423 patients with a history of prior cesarean section, singleton pregnancy with cephalic presentation and gestational age of 37-41 weeks were investigated. The maternal and perinatal outcomes of 195 patients desiring VBAC and undergoing a trial of labor after cesarean (TOLAC) attempt and 228 patients undergoing an ERCD were compared. Results: While the TOLAC attempt was successful in 141 patients (72.3%), it was unsuccessful in 54 patients. No statistically significant difference was determined between VBAC and ERCD patients regarding uterine rupture, dehiscence, post-partum hemorrhage, the need for a blood transfusion and wound site infection (p > 0.05). When the post-partum neonatal outcomes were compared, there was no statistically significant difference between VBAC and ERCD groups regarding the prevalence of admission to the neonatal intensive care unit (NICU), respiratory distress, sepsis and birth injury (p > 0.05). Conclusion: The maternal and perinatal outcomes of our study may be encouraging in favor of VBAC particularly in countries with higher cesarean rates. We think that the option of VBAC should be offered more frequently for selected appropriate patients in created safe environments.

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