Analysis of protein loss in pregnant women. Increased protein analysis. Treatment prognosis and possible complications
Protein in a normal urinalysis is not detected or its content is so insignificant that it is not detected by quantitative methods. More clinically relevant is the daily urine protein content.
Features of the functioning of the kidneys during pregnancy dictate the importance of constant monitoring of its level. Proteinuria during pregnancy is diagnosed if protein production per day exceeds 300 mg.
Causes of high protein content in urine
Pregnancy is a physiological process that requires a woman's body to adapt to changes in the functioning of all organs and systems.
Protein secretion increases due to:
- the formation of lordotic posture (pronounced curvature of the lumbar spine forward, leaning back the upper body, protrusion of the abdomen);
- increased functional load on the urinary system;
- physical pressure of the enlarged uterus on the kidneys and ureters;
- changes in venous outflow.
Proteinuria in a healthy pregnant woman is represented by proteins with a low molecular weight (mainly albumin). In pathological conditions, non-selective proteinuria is detected (proteins with different weights and sizes of molecules, including those exceeding the size of the pores of the glomerular filter).
Proteinuria is mainly a manifestation of exacerbation of pre-existing overt or latent chronic kidney disease, as well as pregnancy toxicosis.
The most often exacerbated:
- pyelonephritis;
- glomerulonephritis;
- diabetes;
- polycystic kidney disease;
- hypertonic disease;
- urinary tract infections;
- systemic diseases.
Proteinuria is transient and permanent, associated with kidney function and independent of the condition of the kidney tissue. It is important to exclude as much as possible the factors that provoke an increased excretion of protein in the urine.
Ways to improve the reliability of the study
High temperature, physical strain, high amount of protein in the diet, hypothermia. Stress can cause temporary proteinuria. In a healthy person, with the termination of the action of the factor that caused the process, it disappears. In pregnant women, the kidneys work in an enhanced mode, therefore, any provocations can trigger the start of a pathological process or cause an exacerbation of a latent, previously not manifested pathology.
- avoid stressful influences;
- exclude from the diet the day before and in the evening a significant amount of cottage cheese, eggs, milk, meat, fish;
- do not overexert yourself and avoid excessive sweating;
- the day before, refrain from using drugs, and if this is not possible, inform the doctor about the drugs taken;
- do not take a cold shower before taking the test.
In addition to provoking factors, it is important to exclude possible technical errors.
Increase the reliability of the analysis:
- use of a container for collecting urine (sterile and non-sterile containers are sold by the pharmacy chain) or a disinfected 200 ml jar;
- preliminary thorough toilet of the genitals;
- the introduction of an intravaginal tampon to prevent the ingress of secretions from the reproductive system;
- collect the middle portion of urine (about 3 seconds after the start of urination, the final portion is also sent to the toilet);
- avoid agitation, shaking during transportation;
- deliver to the laboratory no later than 2 hours after the delivery of the analysis;
- the first morning urine sample is examined.
Using the indicator strips, you can as soon as possible determine the approximate protein concentration
Diagnosis is carried out by examining several tests over a period of time, which is determined by the attending physician. The use of all possible methods of urine analysis and instrumental examination allows you to identify possible diseases. This allows you to timely implement the therapeutic effect and prevent negative consequences.
Clinical manifestations of diseases accompanied by proteinuria
It is necessary to carefully monitor the health of a pregnant woman. Knowledge of the features of the manifestations of a particular pathology, one of the manifestations of which may be an increased excretion of protein in the urine, contributes to the timely seeking of medical help.
Chronic urinary tract infections with a latent (latent) course during pregnancy are manifested mainly by cystitis, pyelonephritis. In addition to proteinuria, with these diseases, the manifestations of inflammation, pain, intoxication syndrome and urinary disorders come to the fore.
Most typically:
- increased body temperature;
- headache;
- nausea, vomiting, impaired appetite, irritability;
- pain, discomfort in the lower back, as well as in the lower abdomen;
- frequent painful urination in small portions.
Systemic diseases (systemic lupus erythematosus, vasculitis) can also become more active during pregnancy. Along with proteinuria and other changes, there are specific symptoms (rash, damage to blood vessels, heart, lungs).
The presence of proteinuria, a number of clinical manifestations, is characteristic of glomerulonephritis. A large daily loss of protein is possible (up to 5 g and more), the presence of erythrocytes (blood cells) and cylinders (casts of various structures of the renal tissue) in the urine. As a rule, there is an edematous syndrome (edema of the eye area is most characteristic) and high blood pressure. In most cases, pre-existing and undiagnosed glomerulonephritis is manifested in this way. The increased burden on the kidneys during pregnancy is the reason that chronic latent (latent) disease manifests itself as a clinically evident exacerbation.
Gestosis is a very dangerous condition that requires immediate medical treatment and medical supervision over the course of pregnancy. It is the development of functional failure of organs and systems of a woman's body due to a violation of the mechanisms of adaptation to pregnancy. If protein in the urine is found after the 20th week of gestation, then this pathology must be excluded first of all.
The disease is based on a spasm of blood vessels, impaired blood circulation in small vessels, the volume of circulating blood decreases, and its coagulability changes. The most affected are the heart, kidneys, brain, liver. Placental vessels do not receive enough oxygen and nutrients, which threatens the normal development of the fetus.
In severe cases, preeclampsia and eclampsia occur.
The main manifestations of preeclampsia:
- severe renal dysfunction;
- high arterial hypertension;
- massive swelling;
- violation of the functioning of the nervous system.
Headaches, nausea, vomiting, visual impairment are observed, changes in the mental sphere are possible.
With eclampsia, the development of convulsive syndrome and dangerous complications for the expectant mother (cerebrovascular accident, hemorrhage) and the fetus (premature placental abruption) are likely.
Glomerulonephritis and late gestosis have similar clinical manifestations, both require immediate medical attention, but different approaches to treatment. Therefore, constant monitoring of the course of pregnancy is important. If possible symptoms appear, you should consult a doctor as soon as possible.
How not to miss the development of pathology
In the normal course of pregnancy, it is enough to take a urine test once a month in the first months, in the second half - monthly. Starting from the 30th week - weekly. With the identified pathology, the frequency of studies, the type of analyzes is determined by the doctor.
You can independently navigate the possibility of proteinuria during pregnancy. The appearance of persistent foam, which does not disappear when urine is allowed to stand for several hours, should alert to the possible high protein content in urine.
Foam in the urine that persists after settling may be a sign of proteinuria
We can confidently talk about pathology only when conducting a few studies. In this case, the general analysis of urine is the first, approximate. To diagnose the disease, an analysis of urine excreted in 24 hours is carried out.
Analysis collection rules:
- the bladder is emptied in the morning, this portion is not examined;
- collection of all excreted urine during the day, night, including the morning portion of the next morning;
- the amount of daily urine received is measured, recorded on a form with the name of the pregnant woman, transported to a medical facility;
- the urine is shaken, poured into a separate clean container of approximately 150-200 ml;
- within 2 hours delivered to the laboratory.
When changes are detected, the doctor determines the following stages of the examination to confirm the diagnosis. This allows you not to miss acute pathology and diseases that can dramatically disrupt a woman's condition.
At the slightest suspicion of late gestosis, hospitalization is indicated, medical observation of the course of pregnancy until its resolution
Activities that reduce urinary protein loss
It is advisable to do the following:
- adhere to a balanced diet and regimen;
- exclude from the diet an excessive amount of meat, fish dishes, dairy products, salted, fried, smoked, spicy foods, strong tea and coffee, chocolate;
- limit the salt content in food;
- reduce the amount of fluid you consume;
- it is better to steam food, bake in the oven, simmer;
- control fluctuations in weight;
- measure blood pressure.
Also, to reduce congestion in the kidneys, it is not recommended:
- sleeping on your back;
- periodically take a knee-elbow position;
- do special gymnastics regularly.
Exercise promotes circulation and kidney function, which can reduce proteinuria
When carrying a child, a woman is under the supervision of doctors. An important part of monitoring the condition of a pregnant woman is routine examinations. The identified changes in the composition of urine must be correctly interpreted in order to take corrective measures in time and prevent negative consequences for the expectant mother and child.
Changes in the work of organs are directly reflected in the chemical composition of tissue fluid, blood, and then - and excretion products.
By examining urine for the presence of substances, by measuring their concentration, it is possible to determine the diagnosis or the direction in which further diagnostics should be carried out.
If, for example, an increased content of protein compounds is found in a biomaterial, one should talk about. This phenomenon can accompany many pathologies, therefore, after its detection, further examination should follow to identify the causes of deviations.
Protein molecules of various compositions are constantly present in the blood, but they enter the urine in extremely small quantities. The norm is the protein content of up to 0.033 g / l in a single serving and up to 30-50 mg in the daily volume of biomaterial.
Deviation from the norm can be expressed in different ways, so doctors determine the degree of proteinuria:
- poorly expressed(at rates of 150-500 mg in the daily volume of urine). It can be a sign of such ailments as obstructive uropathy, chronic, tubulopathy;
- moderately expressed(with indicators of 500-2000 mg). May be accompanied by chronic glomerulonephritis, acute post-streptococcal glomerulonephritis, as well as hereditary;
- pronounced(exceeding the norm by more than 2000 mg). Occurs in nephrotic syndrome.
Distinguish between physiological proteinuria and pathological. In the first case, the ingress of protein compounds into the urine is caused not, but by temporary deviations arising from the strong influence of some factor. For example, young people have an orthostatic form of proteinuria that occurs while standing.
The reasons for this phenomenon have no explanation, but doctors do not associate this deviation with serious health problems. Also, the physiological form manifests itself during physical overload, high temperature or in overweight people.
Microscopic picture of urinary sediment
Sometimes the cause cannot be identified at all, and in such a situation, proteinuria is defined as idiopathic. But all of the above physiological abnormalities lead only to a temporary intake of protein in the urine and are not accompanied by other symptoms associated with (detection in urine a large number blood cells, pain, change physical properties urine).
The pathological form of proteinuria is necessarily associated with any disease. The pathology that provokes the appearance of protein in the urine may be associated with different structures in the body.
Depending on the stage of metabolism and excretion of substances, problems have arisen, the following types of proteinuria are distinguished:
- prerenal. In Latin, the kidney is called "ren", so this name suggests that the violation occurs even before the filtration of primary urine in the glomeruli of the kidney. These can be pathological processes of protein decomposition in tissues or the breakdown of structural elements of the blood;
- renal(that is, directly related to the functioning of the kidneys) may occur due to pathologies in the renal glomeruli or tubules;
- postrenal(associated with structures located below the kidneys). It is provoked by diseases of the urinary organs ( Bladder, urethra), as well as diseases of the reproductive sphere, which is anatomically associated with them.
Causes
Reasons for admission a large number protein in urine can be a wide variety of diseases. They can be divided into several groups:
- inherited genetic defects (cystinosis, galactosemia, Lowe's syndrome);
- diseases and pathological conditions associated with tubular damage (hypokalemia, excess vitamin D, sarcoidosis, disorders in antibiotic treatment and drug use, metal poisoning);
- trauma;
- inflammatory diseases of the organs of the urinary system;
- diseases and pathological conditions associated with damage to the glomeruli, in which filtration occurs (persistent asymptomatic form of proteinuria, glomerulonephritis, Fabry disease, nephrotic syndrome, side effects of drugs);
- diseases associated with the massive breakdown of proteins in various parts of the body (melanoma, urothelial carcinoma, pathologies accompanied by the breakdown of collagen).
Functional proteinuria is provoked by the temporary influence of negative factors (fever, uncomfortable body position, physical stress, hypothermia). In some cases, no reason for such a deviation is found at all.
Often, the reason for detecting protein in urine is not organ dysfunctions, but errors in the collection of biomaterial or the presence of some additional factors.
So, protein substances can get into the urine from the genital opening, while the presence of diseases of the reproductive sphere is not necessary, it can be quite normal physiological secretions.
A positive reaction will also be in the case when the patient takes certain medications or prepares for an x-ray using contrast agents.
Symptoms
The main symptom in proteinuria is the direct detection of protein compounds in the studied biomaterial.
Additional symptoms may also be present, which depends on the specific disease or physiological state of the patient:
- signs associated with loss of protein in the body (bone aches, symptoms of anemia, dizziness);
- signs indicating a clear lack of proteins in the plasma (swelling, foamy urine);
- visible changes in the properties of urine (or clarification);
- symptoms of inflammatory processes in the body (fever, pain, nausea, weakness).
Proteinuria during pregnancy
The appearance of protein in urine during pregnancy is a separate issue that requires special attention from the attending physician.
Such a symptom when carrying a fetus can be triggered both by general causes that can occur in any person (inflammation, hereditary defects, etc.), and by factors specific to the state of pregnancy.
With an increase in the load on the body of a pregnant woman, the urinary system may not cope with the test. There may be a local decrease in immunity (and, as a result, inflammation and infectious infections) or even clamping of the ureters by an enlarged uterus (due to which stagnant processes develop).
The most dangerous and special pathology during pregnancy, which causes the elimination of protein from the body, is gestosis. It manifests itself closer to the moment the baby is born, when the overload of the body reaches its peak. This phenomenon is associated with a violation of vascular permeability and is accompanied by edema and deviations in blood pressure.
This condition requires the closest attention of doctors, since the mother and baby are in real danger.
When carrying a baby, proteinuria, to one degree or another, is very common. Often, such deviations disappear after delivery.
But it is necessary to find out the cause of the violation, and it is worthwhile to undergo diagnostics as early as possible, immediately after the onset of the symptom.
Laboratory diagnostics
Direct evidence of proteinuria is a corresponding laboratory result. To figure out which proteins get into urine, additional biochemical tests are needed for various groups protein compounds. This means that the urine will have to be taken repeatedly both for the purpose of diagnosis and during the treatment period - for monitoring.
The following survey options are possible:
- test for orthostatic proteinuria(urine is taken in a supine position, and then in an upright position);
- analysis according to Zimnitsky(collection of biomaterial is carried out for a long time, while simultaneously controlling the amount of fluid consumed);
- (makes it possible to find out if proteinuria is accompanied by massive ingestion of blood cells into the urine);
- (to study the speed of filtration processes).
To determine the reasons for the ingress of protein into the urine, other diagnostic methods are also needed:
- uroflowmetry;
- x-ray;
- studies of urodynamics.
The exact list of all necessary diagnostic methods depends on the set of symptoms and the results of the studies that have already been performed.
For a correct diagnosis, it is necessary to do all the tests recommended by the doctor.Treatment
The most important step in the treatment of this deviation is the fulfillment of all prescribed examinations and adherence to the doctor's orders. The patient must understand that it is simply impossible to identify the reasons for the disappointing research result alone. It is impossible only by outward signs determine the diagnosis and develop a treatment plan.
The treatment plan depends on the established diagnosis:
- for infectious kidney diseases, antiviral or antifungal drugs are needed (the choice of the drug should be based on the exact determination of the pathogen using tests);
- in the presence of a disease of other organs that provokes proteinuria, treatment of this pathology is necessary;
- the presence of neoplasms (tumors) in the renal tissue requires surgical or appropriate drug treatment;
- If the balance of the content of substances in the body is imbalanced (lack of trace elements, hyper- or hypovitaminosis), their regulation is necessary (the use of calcium, vitamin D or other drugs may be necessary - according to indications).
In some cases, hospitalization is required (for example, with gestosis in pregnant women). The large loss of proteins in the urine, as well as the consequences of the pathologies that caused proteinuria, can be life-threatening. In some cases it is necessary.
Refusal to be admitted to hospital or prescribed medications can be fraught with serious disruptions in the body, caused by the intense loss of protein.Every pregnant woman must have urine tests, including protein tests. What does protein in urine mean during pregnancy? Why is this indicator so important? How to get tested correctly? What is the norm and what to do if there is a deviation?
Why is it important to control urine protein levels during pregnancy?
During childbearing, it is necessary to control the amount of protein in urine, since deviations from the norm indicate a malfunction of the urinary system(especially the kidneys). Observing traces of protein in urine during pregnancy will allow you to timely notice the onset of the disease and cure it.
The amount of protein contained in urine is determined using a general analysis. Here is an algorithm that will allow pass urine correctly:
- prepare a sterile container (it is better to use a plastic container that is sold at a pharmacy);
- in the morning after waking up, wash your genitals thoroughly;
- If you have any vaginal discharge, be sure to cover it with a cotton pad while collecting urine;
- collect a medium portion of urine in a container (50-70 ml is enough);
- deliver the container to the laboratory within a couple of hours.
If the general analysis showed the presence of protein, the doctor may prescribe a change 24-hour urine protein test during pregnancy... To do this, during the day, urine is collected in a large clean jar (it is convenient to use a container with a volume of 2.7-3 liters), and the first morning portion should be poured out.
Before delivery to the laboratory, the contents of the jar are mixed and about 120 ml of urine is poured into another sterile container, but sometimes it is necessary to donate the entire volume of daily urine (before taking the analysis, check with your doctor which method is needed).
The norm of protein in urine during pregnancy: table
The insignificant content of protein in urine can be found in any person. During pregnancy, the kidneys are very stressed, so protein levels often rise.
Normally, this figure does not exceed 0.033 grams per liter. however, in some cases, this figure rises to 0.14 g / l, and this is not considered a serious deviation.
The norm of protein in daily urine during pregnancy is 50-100 mg / day.
Increased protein in urine during pregnancy: what is dangerous and causes
What does high urine protein mean during pregnancy? There are many the reasons for the appearance of an increased amount of protein in the urine a woman who is carrying a child:
- improper collection of urine (contaminated container, poorly washed genitals);
- physical activity and nervous shock before collecting urine for analysis;
- eating a lot of food that contains protein (dairy products, eggs);
- pyelonephritis (in addition to protein, urine contains, and a woman may have fever and pain in the lumbar region);
- gestosis, dropsy, eclampsia and nephropathy (these diseases appear at the end of the second trimester, they are very dangerous for the baby);
- glomerulonephritis, or acute inflammation of the kidneys (from concomitant symptoms: urine staining pink or red, the presence of leukocytes and erythrocytes in urine).
Re-analysis of urine for protein: what is it for
To confirm the increased amount of protein, the doctor will definitely prescribe a change reanalysis, since not always a one-time deviation from the norm indicates the presence of pathologies.
False proteinuria(high protein content) in a woman during pregnancy may be the result of nervous shocks, excessive physical exertion or the use of certain foods. In this case, the results of the repeated analysis will be within the normal range.
Treatment for high protein in urine during pregnancy
How to lower urine protein during pregnancy? First of all, the doctor must determine the exact reason for the increase in protein in the urine... In case of a strong deviation from the norm, the doctor will recommend fighting the disease in a hospital setting.
For every disease there is own treatment regimen:
- Pyelonephritis and other inflammatory processes... For treatment, antibiotics are used (in the chronic and acute course of the disease), herbal anti-inflammatory drugs (Canephron or Phytolysin) and diuretics. It is not recommended for a pregnant woman to sleep on her back a lot. With such diseases, it is useful to stand on all fours more often and walk a lot.
- Gestosis. This condition is very dangerous for both the mother and the unborn baby. With gestosis, there is a great risk premature birth... With this ailment, a woman must follow a diet that will reduce the amount of protein (chocolate, coffee, citrus fruits, junk food, spices, carbonated drinks are excluded from the diet). If available, reduce fluid intake.
Prevention of high protein in urine
Compliance with the following preventive measures can help to avoid the appearance of large amounts of protein in urine:
- weigh yourself regularly and do not admit the strong;
- , exclude products that are harmful and dangerous for the kidneys from the menu;
- measure your blood pressure regularly;
- drink as much fluids as your doctor tells you to;
- if you feel a deterioration in well-being, be sure to inform a specialist about it.
Video about the level of protein in urine during pregnancy
We suggest watching a video that tells about the protein content in urine during pregnancy.
Having timely suspected the presence of dangerous infections or diabetes mellitus, specialists will be able to take all the necessary measures to carry out procedures that improve the situation in the future. The presence of protein in the urine of pregnant women, which is extremely undesirable and dangerous, can also serve as a signal for appropriate action.
The norm of protein in the urine of the expectant mother
According to many experts, the first prerequisite for taking the necessary measures is an increase in the level of protein in the urine of a pregnant woman higher than 0.033 grams per liter. At the same time, 0.08-0.2 grams is considered to be the norm. protein excreted in the urine of the expectant mother per day.
The detection of an increased level of protein in the urine of a woman during the period of gestation during the next analysis implies the regular repetition of this procedure. Periodic laboratory results obtained will be able to demonstrate the dynamics of changes in indicators.
A one-time or permanent increase in the protein level in the urine of a woman during pregnancy in the language of doctors is proteinuria. The correctness of the test result, indicating problems, can be affected by:
- eating milk, cottage cheese or eggs before visiting a specialist and taking an analysis;
- taking medications;
- cold shower and profuse sweating before filling the jar;
- high body temperature;
- excessive physical activity;
- stress.
Causes of proteinuria
Proteinuria can be caused by a natural process in the body of the expectant mother. In this case, an increase in the size of the uterus, which prevents the normal blood supply to the urinary ducts and kidneys. Possible consequences- inflammation of the urine excretion system. This factor implies the need to visit a nephrologist or urologist throughout the entire period of gestation.
A number of diseases can also provoke an increase in the level of protein in the urine of a woman preparing to become a mother. Such diseases include:
- hypertension;
- diabetes;
- polycystic kidney disease;
- glomerulonephritis and pyelonephritis, related to infectious kidney disease;
- urinary tract infections;
- congestive heart failure.
To the most dangerous condition associated with an increase in the level of protein in the urine, doctors refer preeclampsia... This pathology is classified as kidney disease, leading to malfunctioning of the placenta. Such a failure in the mother's body is especially dangerous for the baby in the womb. The fetus ceases to receive oxygen and nutrients in the required quantities, remains unprotected properly. In such cases, the likelihood of premature birth or stopping the development of the fetus in the mother's abdomen increases. An even less comforting result is possible - the child may be born dead.
The danger of gestosis also lies in the peculiarities of the course of the disease. Being in a position, a woman may not be aware of the presence of problems. Protein in the urine of a pregnant woman in this case is the only evidence of a threatening condition.
There is another significant nuance: a woman can be in a state of gestosis only during the period of gestation, after childbirth this problem disappears.
Treatment
An increased level of protein in the urine during pregnancy really indicates the need to take the necessary measures, but you should not panic. According to doctors, tests confirming the presence of pathology are especially alarming if:
- diagnostics were carried out several times;
- in parallel with urine analysis, tracking was carried out blood pressure;
- there is one hundred percent confidence that the container was absolutely clean;
- By collecting urine, the woman produced the necessary toilet for the external genitalia.
The determination of the further treatment system for a pregnant woman with an increased protein content in the urine is carried out by a specialist based on the characteristic symptoms.
Diuretics and herbal preparations that stop the inflammatory process in the kidneys will be prescribed by the doctor for pyelonephritis. In the case of a chronic and acute form of the disease, the expectant mother will be prescribed a course of antibiotics. With this diagnosis, your doctor will probably recommend being in motion more.
Often, high protein levels associated with kidney disease decline rapidly. Otherwise, the likelihood of gestosis is high, which implies the adoption of more serious measures.
The process of treating preeclampsia is rather complicated. The main efforts of physicians in such a situation are aimed at stabilizing the indicators of the body's work and maintaining them at the required level in the future until the moment of childbirth. Although the likelihood of the risk of premature birth with gestosis is high, full bearing of the fetus for 9 months is also quite possible.
The death of a mother and child is the worst outcome. In order to avoid the irreparable, experts may suggest the patient to terminate the pregnancy. However, the decision remains with the mother-to-be. Taking such a step, a woman in a position must strictly follow the following instructions:
- go to the hospital;
- strictly observe all the requirements and recommendations of specialists.
It is also important to be aware of the need to conduct caesarean section during childbirth: giving birth on your own with gestosis will not work.
Prevention of gestosis
Realizing the seriousness of the situation, and refusing inpatient treatment of gestosis, a woman in a position should pay special attention to the nutrition and state of her body. It is obligatory to measure pressure twice a day, ignoring is strictly contraindicated:
- Darkening in the eyes;
- Ringing in the ears;
- Headache.
The tendency to edema implies the strictest control of the amount of fluid consumed. The mass of the drink taken should not exceed the mass of excreted urine.
Controlling your own weight is essential. Gaining extra pounds is an alarming bell, suggesting the progression of preeclampsia.
Phytozolin, kanefron - herbal preparations, the intake of which helps to improve kidney function. In practice, the effectiveness of lingonberry and cranberry juice, herbal tea has also been proven. When receiving them, prior consultation with a specialist is required.
It is advisable to reduce the consumption of fermented milk products, as well as:
- smoked meats;
- pepper;
- salt;
- meat with a crust;
- chocolate;
- strong tea;
- coffee.
How to properly collect urine so that there are no false results?
Waiting for the baby to be born future mom is obliged to periodically take a urine test at the appropriate time:
- 1st half of pregnancy - every month;
- 2nd - once every two months.
As medical practice shows, the degree of correctness of the results obtained in a laboratory study of the urine of a woman in a position depends on certain factors. One of them is the seriousness of preparation for the procedure itself. Experts strongly recommend paying special attention to the following points before going to the gynecologist:
- you should not eat meat, spicy, salty and sour dishes on the eve of visiting a doctor;
- the container for collecting urine must be perfectly clean;
- a woman must thoroughly wash herself with soap before filling the jar.
In this case, there is another the most important moment... For analyzes, the so-called middle urine must be collected. This means the following: the first three seconds you need to urinate in the toilet, then fill the previously prepared container. The delivery time of the sample to the laboratory is also important: ideally, the jar with the contents should be at the analysis site within two hours.
The increased rhythm of the kidneys is one of the features of the state of the body during pregnancy. Laboratory research urine will assess the correct functioning of these organs.
During pregnancy, a woman regularly visits a gynecologist, and takes tests before each appointment in order to diagnose various pathologies in a timely manner. The results of urine analysis are very important, and first of all, the doctor is interested in protein indicators. What does protein in urine mean during pregnancy, and how to reduce it, can only be said by a doctor after a full examination of a pregnant woman.
Why is proteinuria dangerous in pregnant women?
In a healthy woman, in the analysis of urine, protein should be absent or not exceed 0.033 g / liter, protein in urine during pregnancy may normally have slightly different indicators depending on the period.
The norm of protein in urine during pregnancy fluctuates within the following ranges:
At the same time, the permissible daily rate is 0.08-0.2 g / day.
If this indicator is exceeded, then proteinuria is diagnosed during pregnancy. Most often it is observed on later dates- after 30 weeks. Increased protein in urine during pregnancy indicates that the health of the mother and child may be at risk.
Analysis of urine for protein during pregnancy is necessary, since its excess can signal the development of dangerous pathologies. The greatest harm can bring preeclampsia - pathological condition second and third trimester, accompanied by edema, high blood pressure and seizures.
It most often occurs in women with pyelonephritis, diabetes and hypertension. Pregnant women from 36 years of age are at risk.
There are four degrees of gestosis:
What is the danger of gestosis of the first three stages for the mother:
- Nervous system disorders.
- Pulmonary and heart failure.
- Diseases of the liver and kidneys.
- Thrombosis.
- Loss of vision.
- Stroke.
- Dehydration.
- Swelling of the brain.
- Coma.
- Bleeding after childbirth.
Important! Gestosis can provoke placental abruption, fetal hypoxia, premature birth.
Late gestosis is dangerous for the mental and physical health of the child, it causes:
Pyelonephritis and other infectious diseases during pregnancy cannot be ignored. Lack of treatment can lead to unpleasant and sometimes fatal consequences:
- Early miscarriage.
- Premature birth.
- Kidney abscess in the mother or development of phlegmon.
- Infection of the fetus.
The consequences of intrauterine infection of a child can be mild - conjunctivitis in a newborn, or severe - infection of internal organs or their abnormal development.
Important! An increase in protein in pregnant women for any reason affects the child - he receives less oxygen than necessary, which leads to hypoxia. The consequences of this condition affect the overall development of the infant.
Causes of the appearance of protein
When the norm of protein in urine is exceeded, it is necessary to retake OAM and analysis for daily protein excretion several times.
An experienced doctor will certainly take an interest in what the woman ate on the eve of the tests. Eating protein foods - milk, eggs, cottage cheese - can affect the numbers as a result.
A slight excess of the indicator up to 46 mg / liter may not be a pathology, but only physiological proteinuria, which goes away on its own after the elimination of provoking factors.
What does protein in urine mean for physiological proteinuria:
- Physical fatigue.
- Stressful situations, neurosis.
- Dehydration.
- Taking certain medications and vitamins.
- Excessive consumption of protein foods.
It is very important to take the analysis correctly - the ingress of epithelium from the vagina and external genital organs can cause inaccurate results.
Proteinuria can occur with exacerbation of chronic diseases, colds, inflammatory processes in the body, allergies. Hormonal changes during pregnancy can affect renal blood flow and glomerular permeability, which leads to the passage of protein into the urine. This condition does not require treatment and goes away by itself after childbirth, the main thing is to conduct a thorough diagnosis and exclude other pathologies.
The main reason for the appearance of protein after 30 weeks of pregnancy is the intensively growing uterus, which compresses the vessels that feed the kidneys and ureters, and supports internal organs which can lead to urinary stagnation.
In this case, a favorable environment is formed for the development of infection.
In the presence of protein in urine during pregnancy, the reasons for this period may be as follows:
- Pyelonephritis.
- Cystitis.
- Urethritis.
Most often, these pathologies occur in the 2nd and 3rd trimester, but they can be observed for more early dates, especially if there is a tendency to develop them. Most often, it is necessary for women with chronic diseases of the urinary system to be tested for protein in urine during pregnancy.
What else can provoke an increase in protein in the urine:
Sometimes, traces of protein are found in the urine during pregnancy. This means that too much of the burden is placed on the kidneys and there is a risk of complications. This is most often observed at the 9th month of pregnancy. Also, the presence of traces can signal an early stage of gestosis.
If, with repeated tests, the results do not change or become worse, then hospitalization is required. Even a slight deviation from the norm after 36 weeks of pregnancy requires a woman to be in the hospital, where she will undergo a full examination.
A high protein in urine after childbirth may mean that an inflammatory process begins in the kidneys and organs of the urinary system. Therefore, before discharging a woman with a child from the hospital, blood and urine tests are performed.
Sometimes a slight excess of protein in a woman in labor can be considered normal if proteinuria was diagnosed at 9 months of pregnancy, for example, after gestosis. In this case, the body needs to recover, usually it takes 6-9 weeks, depending on the condition of the woman in labor.
Ways to normalize protein levels
When protein is found in the urine of pregnant women, it is necessary to determine what caused the condition.
For diagnosis, OAM and 24-hour urine should be re-passed, other tests may be needed: a study according to Nechiporenko, Zimnitsky, culture tank and antibiotic sensitivity. An ultrasound examination of the kidneys is mandatory.
If an infectious disease is confirmed, then antibiotic therapy is prescribed. Pregnant women should remember that the disease itself can lead to more trouble than a course of antibacterial drugs. Do not be afraid to take antibiotics, there are drugs that do not pass through the placenta and do not harm the fetus:
- Amoxicillin;
- Augmentin;
- Ceftriaxone;
- Rovamycin;
- Sumamed and others.
In case of inflammatory processes in the kidneys, preparations are prescribed based on plant raw materials that have anti-inflammatory, diuretic and mild antiseptic effects: Canephron or Phytolysin. These remedies help reduce inflammation and pain without harming the baby.
With a high protein, if there are no infectious and inflammatory processes in the kidneys, nephropathy or gestosis of pregnant women is most likely diagnosed. In this case, it is necessary to control the level of pressure, weight gain and make sure that swelling does not form.
The main way to get rid of excess protein is to follow a healthy diet. You should reduce the use of salt to a minimum, cook food without oil, preferably steamed, baked or boiled.
50% of the diet should consist of fresh vegetables and fruits, low-fat cottage cheese, kefir, milk. From week 36, even healthy women need to follow a low-calorie diet, but high in vitamins. This helps to unload the body before childbirth and improve blood circulation.
You can reduce the level of protein with the help of herbal decoctions and berry fruit drinks. At 9 months, cranberry juice is especially useful, which helps to remove excess fluid from the body and relieves edema..
How to reduce protein in urine during pregnancy with folk remedies:
- Boil a spoonful of parsley seeds in a glass of water... Drink during the day in small portions.
- Brew birch buds and leaves in a thermos... For 500 ml of water, take 3 tbsp. spoons of raw materials, infuse overnight. Drink half a glass 3 times a day.
- Pour a tablespoon of lingonberry sheets with a glass of boiling water, leave for 30 minutes. Drink 1-2 glasses a day.
For the treatment of proteinuria, you can use the following plants: St. John's wort, chamomile, bearberry, juniper and others. But their use must be approved by the attending physician. You also need to maintain a moderate locomotor activity, which will not allow stagnation in the kidneys.