Maternal and Fetal Outcomes in Pre-eclamptic Patients – Differentiation Based on the Level of Proteinuria in tertiary care centre

Background Pre-eclampsia is a significant contributor to maternal and fetal morbidity and mortality. Although recent guidelines have de-emphasized proteinuria as essential for diagnosis, the degree of proteinuria may still reflect disease severity [1]. The objective of this study is to evaluate maternal and fetal outcomes in pre-eclamptic women stratified by levels of proteinuria. Methods A cross-sectional observational study included 320 pregnant women diagnosed with pre-eclampsia. Based on spot urinary protein /urinary creatinine ratio (p/c), participants were classified into Group A (< 0.3 g), Group B (0.3–2 g), and Group C (≥ 2 g). Maternal and fetal outcomes were compared across these groups using appropriate statistical tests. Results A significantly higher proportion of women in the high-proteinuria group had elevated systolic and diastolic blood pressures. Emergency caesarean section and severe pre-eclampsia were most frequent in the high-proteinuria group. On subgroup analysis, birthweight < 2.5kg was clinically significant in patients with proteinuria of more than 2 grams. However, no statistically significant differences were found among the groups regarding age, BMI, gestational age at booking/delivery, laboratory parameters, or most fetal outcomes. Conclusion Higher levels of proteinuria are associated with increased maternal complications, particularly severe hypertension and preeclampsia, but not necessarily with worse fetal outcomes.