Although the gold standard, the 24 h urinary protein is subject to inaccuracies due to incomplete collection of the specimen or the effects of dehydration. Variation in the 24 h urinary protein measurement due to such factors could be minimized if a 24 h protein creatinine ratio was used rather than the absolute 24 h protein excretion. Further research is necessary to determine the threshold value for an abnormal 24 h protein creatinine ratio in pregnancy. There is no international agreement on the optimal laboratory method to measure urinary protein, and a range of methods (e.g. turbidometric methods such as the benzethonium chloride method, Coomassie brilliant blue dye-binding) are widely used. The lack of a universal method to estimate urinary proteins, alters the range of proteins that are measured and consequently the levels reported (Waugh et al., 2001). This inevitably limits comparison of values between different centers, a fact not widely appreciated.
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