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Br J Obstet Gynaecol. 1999 Nov;106(11):1177-80.

The role of observer error in antenatal dipstick proteinuria analysis.

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1
Department of Obstetrics and Gynaecology, University of Leicester, UK.

Abstract

OBJECTIVE:

To determine the role of inter-observer error and the influence of training upon dipstick urine analysis.

DESIGN:

A two phase observational and training study.

METHODS:

Five standard solutions of serum albumin were used to test the accuracy of midwives and nursing auxiliaries involved in dipstick urine analysis at a maternity hospital. The standard solutions were chosen such that they should have resulted in negative (n = 2) and positive (n = 3) dipstick test results, respectively.

SETTING:

A teaching maternity hospital and academic department of obstetrics and gynaecology.

PARTICIPANTS:

Twenty midwives, 20 nursing auxiliaries and nine laboratory technicians.

RESULTS:

For the two nonproteinuric solutions, a higher false positive rate was observed for nursing auxiliaries (40% and 55%), compared with midwives (5% and 30%) (P = 0.020 and P = 0.20, respectively). Before training, laboratory technicians recorded high false positive rates (67% and 89%), but after training these were reduced to 0% and 22% (P = 0.25 and P = 0.023, respectively). Both nursing auxiliaries and midwives recorded false negative rates of between 10% and 45% for the three proteinuric solutions.

CONCLUSIONS:

Observer error may be reduced by assigning midwives to urine dipstick analysis or by the implementation of directed training. Classification of pre-eclampsia or other hypertensive diseases of pregnancy on the basis of the presence and degree of proteinuria should be confirmed with a 24-hour quantitative protein collection.

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PMID:
10549963
[Indexed for MEDLINE]

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