Diagnosing preeclampsia in 3 minutes by urine test

  • EClinicalMedicine

  • International Clinical Digest
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Takeaway

  • Urine test (CRD Paper Test) shows promise in correctly diagnosing preeclampsia (PE).

Why this matters

  • 70,000 women die each year from PE.
  • Misfolded proteins have been identified in the urine of women with PE. 
  • These proteins have an affinity toward the azo-dye Congo Red (congophilia).
  • Spot test can save time and may prevent misdiagnosis.

Key results

  • Urine congophilia was detected in 12% of patients with an uncertain diagnosis and 58% with a diagnosis of PE.
  • CRD Paper Test to confirm and rule out PE was more accurate compared with all other serum biomarkers.
  • A positive CRD Paper Test correctly diagnosed PE:
    • 80.2% sensitivity,
    • 89.2% specificity,
    • 92.1% negative predictive value, and
    • 86.7% accuracy.

Study design

  • Simple bedside, paper-based CRD Paper Test compared with routine assessment for PE.
  • Main outcome: area under the curve to confirm and rule out PE.
  • Consecutive pregnant patients presenting for evaluation for PE (n=353) included.
  • CRD Paper Test administered; clinical team blinded to results.
  • Medical decisions based only on clinical findings.
  • Funding: USAID; SLaB; Bill and Melinda Gates Foundation; NIH; others.

Limitations

  • Further validation studies needed.

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