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Re: The end of dipsticks? From: Elrod Darryl G MAJ 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL) Tue Nov 15 05:13:44 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: There are no Home Births" Previous message: Peter Wein: "Re: The end of dipsticks?" Maybe in reply to: Anna Meenan, MD: "The end of dipsticks?" Next in thread: DoctorJoe@aol.com: "Re: The end of dipsticks?" The DOD did a literature review about 2-3 years ago and found essentially this same suggestion that they aren't of much value. We stopped using them routinely (supposedly military wide) 2 years ago. Glen -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain Ramirez Sent: Tuesday, November 15, 2005 10:49 AM To: Multiple recipients of list OB-GYN-L Subject: Re: The end of dipsticks? I use them selectively..for proteinuria.. Ef >At Mon, 14 Nov 2005, Anna Meenan, MD wrote: > >What do y'all think? > >-- > Anna Meenan, MD, FAAFP > >Routine dipstix for protein and glucose at each antenatal visit is not >needed > >To identify the scientific evidence to support routine urine screening >for gestational diabetes and preeclampsia, researchers in Maine, USA >searched Medline (1966-2004), the Cochrane review, AHRQ National >Guideline Clearinghouse, the Institute for Clinical Systems Improvement, >and Google, for studies on proteinuria or glycosuria in pregnancy. They >found 6 studies investigating glycosuria as a predictor for gestational >diabetes mellitus, or proteinuria as a predictor for preeclampsia (1 >examined both). Because every study used different dipstick methods of >determining results, or definitions of abnormal, each was evaluated >separately. > >They found "Glycosuria is found at some point in about 50% of pregnant >women; it is believed to be due to an increased glomerular filtration >rate. The renal threshold for glucose is highly variable and may lead >to a positive test result for glycosuria despite normal blood sugar. >High intake of ascorbic acid or high urinary ketone levels may result in >false-positive results. Four published studies assessed the value of >glycosuria as a screen for gestational diabetes. All used urine >dipsticks. Three of the four most likely overestimate the sensitivity >of glycosuria for predicting gestational diabetes." > >The researchers concluded "Routine dipstick screening for protein and >glucose at each prenatal visit should be abandoned. Women who are known >or perceived to be at high risk for gestational diabetes or preeclampsia >should continue to be monitored closely at the discretion of their >clinician" > >The Journal of Family Practice November 2005. Vol. 54, No. 11(c)2005 >Dowden Health Media >No need for routine glycosuria/proteinuria screen in pregnant women. >William A. Alto, MD, MPH. Correspondence to William A. Alto >waalto@dartmouth.edu > >Category W. Pregnancy, Childbirth, Family Planning, U. Urinary System, >T. Endocrine/Metabolic/Nutritional. Keywords: antenatal, screening, >glycosuria, proteinuria, preeclampsia, diabetes, literature review. >Synopsis edited by Dr Jim Vause, Blenheim, New Zealand. Posted on >Global Family Doctor 15 November 2005 > -- Have the courage to be ignorant of a great number of things, in order to avoid the calamity of being ignorant of everything. Sydney Smith (1771 - 1845) ~walt whitman~ Next message: DoctorJoe@aol.com: "Re: There are no Home Births" Previous message: Peter Wein: "Re: The end of dipsticks?" Maybe in reply to: Anna Meenan, MD: "The end of dipsticks?" Next in thread: DoctorJoe@aol.com: "Re: The end of dipsticks?"

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