Significance of Urine Kallikrein in the Prediction of Pregnancy-induced Hypertension

Abstract

A total of 158 urine kallikrein and creatinine levels were measured in 127 normotensive gravid women and 12 non-pregnant women and the kallikrein/ creatinine ratio was evaluated to predict pregnancy induced hypertension. Urine kallikrein was examined using the MCA fluorescent method. Twenty-seven patients ultimately developed pregnancy-induced hypertension. In normotensive pregnant women, the urine kallikrein/creatinine ratio was significantly higher than that of non-pregnant women, especially during the first half of pregnancy. The mean urine kallikrein/creatinine ratio in patients destined to develop pregnancy-induced hyper tension was lower than that of normotensive pregnant women at each gestational week and the difference was statistically significant at > 32 weeks of gestation. When a kallikrein/creatinine ratio of less than 1.60 U/g creatinine was considered to represent a positive test, the predictive value of a positive test was high (71.4% at 32-35 weeks of gestation and 83.3% at > 36 weeks of gestation), and there were no false nagative results at >32 weeks of gestation. The mean value of the latent period (interval between the time of a positive test result and the onset of preg nancy-induced hypertension) was 5.4 weeks. Evaluation of the urine kallikrein/ creatinine ratio may be a useful screening tool in predicting the subsequent devel opment of pregnancy-induced hypertension. (Thai J Obstet Gynaecol 1991;3:63 70.)