MATERNAL PROTEINURIA IN TWIN COMPARED WITH SINGLETON PREGNANCIES

Abstract

INTRODUCTION: The exact amount of albumin ltered each day by kidneys is controversial. Normal rate of albumin excretion is less than 20 mg/day. The upper limit of the urinary protein excretion is 150 mg/d in normal non–pregnant women. Total protein excretion, however, increases to 150-250 mg daily in normal pregnancy due to increase in blood volume and, therefore, the glomerular ltration rate. This study was conducted to compare 24 hour urinary protein excretion in twin and singleton pregnancies, not complicated by hypertension. MATERIALS AND METHODS: This is a prospective study done in the department of Obstetrics and Gynaecology in R.G.Kar Medical College and Hospital, Kolkata from June, 2015 to May, 2016. A total of 86 women (43 twin and 43 singleton pregnancies) participated in this study. Six collections were inadequate based on creatinine excretion and were excluded. So, 80 women (40 twin and 40 singleton pregnancies) comprised the nal cohort. RESULT: In our study four twin pregnancies (ten percent) were found to have proteinuria ≥ 300 mg/day at the time of the specimen collection but no singleton pregnancy had this level of proteinuria. And only one of these twin pregnancies (who had proteinuria ≥ 300 mg/day ) subsequently developed hypertensive disorder in pregnancy. Rest three twin pregnancies were normotensive, yet they showed proteinuria ≥ 300 mg/day. Though statistical analysis of 24 hour urine protein ≥ 300 mg in singleton and twin pregnancies did not show signicans (P0.1238) in our study. CONCLUSION: Twin pregnancy had signicantly more proteinuria as measured by 24 hour urine protein, than singleton pregnancy. And they are more likely to have proteinuria without hypertension and this value can exceed 300 mg/day. So, a reevaluation of the diagnostic criteria for preeclampsia in twin pregnancies is needed.