The kidneys are a biological filter for all substances dissolved in the blood. They remove excess liquid, salts, toxic and waste substances. Therefore, monitoring kidney function during pregnancy is one of the most important tasks. To do this, regular urine tests are performed.

A general urine test is taken before each visit to an obstetrician-gynecologist at the clinic; additionally, other urine tests are performed as prescribed by the doctor. This is necessary in order to promptly identify abnormalities in the functioning of the kidneys, the inflammatory process, and the development of preeclampsia.

Urine during pregnancy.

In a urine test during pregnancy, the doctor will evaluate both physical and chemical indicators - color, clarity, presence of sediment, density (specific gravity) and pH, and inorganic urine sediment - the amount of formed elements, salts, microbes, protein.

The acidity or pH of urine will depend on diet: with a predominantly plant-and-dairy diet, the urine will be slightly alkaline, and with an abundance of meat, it will be acidic.
The specific gravity of urine indicates the degree of dissolution of salts and other substances (glucose, protein) in it. A sharp increase in specific gravity may indicate impaired renal function or the presence of serious diseases (diabetes, nephropathy).

How to donate urine during pregnancy.

The result can significantly depend on the quality of urine collection for analysis during pregnancy. Before donating urine, you should not eat highly coloring or diuretic foods (watermelons, melons, cucumbers), drink coffee, or take medications that can affect the composition of urine.

Urine for general analysis is collected in the morning, immediately after sleep, after thoroughly washing the external genitalia with soap. Pee into a sterile cup or jar: only a medium portion is needed, approximately 30-50 ml. It must be brought to the laboratory within one to two hours to avoid distorting the results.

Main indicators and possible deviations from the norm in the analysis

Let's look at the main indicators of urine analysis.

Acetone in urine during pregnancy.

The acidity of urine changes during toxicosis with vomiting, causing both acidification of the urine and its alkalization, depending on the measures taken and the severity of vomiting. One of the signs of toxicosis and its fairly pronounced condition is the appearance of acetone (ketone bodies) in the urine. They change the pH of urine to the acidic side.

Cloudy urine during pregnancy.

If the clarity of urine is impaired, one may suspect the presence of mucus, microbes or leukocytes, or protein in it, which indicates a serious inflammatory process in the kidneys or urinary system. The appearance of sediment may indicate urolithiasis or metabolic disorders.

Protein in urine during pregnancy.

One particularly alarming indicator in the urine of pregnant women is protein. In a healthy woman, it should normally be absent, but during pregnancy, especially in its later stages, traces of protein in the urine, determined by machines, are quite acceptable. They are designated in the analysis form by the term “trace”. These are features of the blood circulation of the kidneys and the result of increasing loads on them.

An increase in the amount of protein in a general urine test serves as a signal for a more detailed examination of the woman and a urine test for daily protein levels. An increase in protein levels above 300 ml (0.033 hl) may indicate the development of a serious pregnancy complication - nephropathy or. Also, the appearance of protein in the urine can be a sign of infectious and inflammatory kidney diseases - glomerulonephritis, nephrosonephritis. In such conditions, immediate hospitalization in a hospital, a comprehensive examination and treatment is necessary, and if the pregnancy is older and there is a progressive deterioration in kidney function, early delivery is necessary to save the life of the child and mother. Nephropathy leads to increased blood pressure and the development of dangerous complications in the form of preeclampsia and eclampsia, which can dramatically disrupt the nutrition of the placenta, cause convulsions in the mother and death of the fetus.

Bacteria in urine during pregnancy.

During pregnancy, bacteria are often detected in a general urine test in women. This phenomenon is quite common and is due to the structural features of the genitourinary system of women, proximity to the genitals of the rectum and weakening during pregnancy of the immune defense of the mucous membranes from microbial attacks. The appearance of microbes in the urine may be a defect in urine collection and a consequence of insufficient genital hygiene, or may be a symptom of a serious urinary tract infection - , cystitis. Escherichia coli or staphylococcus are especially common in urine.

A separate option could be asymptomatic bacteriuria: the appearance of microbes in the urine in the complete absence of signs of inflammation from the genitourinary tract. This condition requires close monitoring by a doctor, as it may be the initial stage of serious kidney and bladder infections. Asymptomatic bacteriuria with a large number of microbial bodies in a milliliter of urine can lead to premature birth, threatened miscarriage, intrauterine infection of the fetus, and other complications.

If microbes are detected in a general urine test, additional urine culture is performed during pregnancy. This analysis is carried out according to general rules, but urine is collected in a sterile cup and sown on special media, detecting the number and type of microbes in the urine, as well as determining the sensitivity of these microbes to antibiotics.

Leukocytes in urine during pregnancy.

The presence of leukocytes in the urine indicates an inflammatory process in the genitourinary system. Depending on the type and number of leukocytes, the level of damage to the urinary system can be suspected. These may be the kidneys or the renal pyelocaliceal system, the ureters and bladder, and the urethra. When there are a large number of leukocytes in the urine, visible to the eye as lumps of mucus and flakes, they speak of pyuria (pus in the urine). This is accompanied by a serious condition for the pregnant woman, and is extremely dangerous for the fetus - it can threaten intrauterine death, premature birth, and placental problems.

Red blood cells in urine during pregnancy.

The appearance of red blood cells in the urine is an unfavorable symptom, since Normally, they should be completely absent in a pregnant woman.. Blood in the urine can manifest itself as microhematuria, that is, a very small number of red blood cells. This happens with cystitis, urolithiasis, pyelitis, and in the initial stage of gestosis. Sometimes blood in the urine is visible to the naked eye, which is called gross hematuria or “meat-slop-colored urine.” This occurs with nephritis, glomerunonephritis with nephrotic syndrome, with severe gestosis. These conditions are extremely dangerous for the mother and fetus and require immediate hospitalization and active therapy, and sometimes an emergency caesarean section to save the baby and the mother herself.

Sugar in urine during pregnancy

If suspected or the level of glucose (sugar) in the urine is determined. When carbohydrate metabolism is disturbed, associated both with pregnancy itself and with the onset of diabetes, as a result of an increase in the level of glucose in the blood, its excess is filtered into the urine. Typically, an increase in sugar levels is accompanied by an increase in the density of urine, a sharp increase in the volume of urine excreted (up to three to five liters) and severe thirst.

Bad urine during pregnancy.

There are a number of conditions, the manifestation of which requires immediate consultation with a doctor or calling an ambulance. First of all this:

• acute decrease in the amount of urine up to its retention for more than 8-12 hours;
• the appearance of blood in the urine;
• severe turbidity of urine with fever, lower back pain, general malaise;
• cloudy urine combined with high blood pressure, double vision and swelling;
• passing large quantities of urine with great thirst, weakness and malaise.

The end products of metabolism, excess water, salts, some hormones, enzymes and vitamins are removed from the body with urine. A general urine test allows us to get an idea of ​​the condition of not only the kidneys, but also other organs: the heart, liver, and gastrointestinal tract.

Information During pregnancy, a general urine test is taken upon registration and then before each visit to the doctor.

The result of the study largely depends on the correctness of the conditions for urine collection:

• The day before the test, do not consume any coloring foods (beets, carrots);
• Stop taking diuretics and other medications (in consultation with your doctor) also one day before the test;
• It is advisable to avoid heavy physical activity the day before the test - this may affect the concentration of protein in the urine;
• Immediately before collecting urine, it is necessary to thoroughly clean the external genitalia, wash the jar well and dry it. The study requires an average portion of urine, a volume of more than 70 ml for a more accurate determination of density;
• You can store collected urine for no more than 1.5 - 2 hours.

Urine test interpretation

Physical properties of urine:

Quantity morning urine is usually 150 - 250 ml and does not give an idea of ​​daily diuresis. Measuring the quantity is necessary to determine the density of urine.

Color depends on the volume of urine excreted and the amount of coloring pigments. Normal urine color is straw-yellow, due to the presence of the urinary pigment urochrome.

Transparency urine reflects the properties of the substances it contains. Normally, all substances are in solution, so fresh urine is absolutely transparent.

Density (specific gravity) depends on the concentration of substances dissolved in the urine (protein, glucose, urea, salts).

Chemical examination of urine:

Acidity of urinePh determined by the concentration of hydrogen ions H +, which are formed during the dissociation of organic acids and acid salts of inorganic acids contained in urine.

A healthy woman is practically not defined. This is due to tubular reabsorption of protein filtered in the glomeruli. The detection of protein in the urine is called proteinuria. It can be physiological and pathological. In uncomplicated pregnancy, orthostatic proteinuria (protein concentration in urine up to 0.033 g/l) can sometimes be detected. The cause may be compression of the inferior vena cava by the liver and the uterus of the renal veins. Physiological proteinuria also includes the appearance of protein in the urine after eating a large amount of protein food, after intense physical activity, or emotional stress.

Glucose, that gets into the primary urine is also completely reabsorbed in the renal tubules, and cannot be detected by standard methods. Glucose is detected in the urine when its concentration in the blood increases above the renal threshold - 8.8 - 9.9 mmol/l or when the renal threshold decreases (diabetes mellitus).

important Physiological short-term glucosuria can also occur in healthy people with a large amount of carbohydrates in the daily diet, with. Glucosuria during normal pregnancy is associated with an increase in glomerular filtration of glucose.

Bilirubin It is not detected in the urine of healthy people, because only direct bilirubin, the content of which in the blood is insignificant, can pass through the glomerular filter. And there is a very small amount of it in the urine, which is not detected by qualitative samples.

Urobilinogen is formed from bilirubin in the intestine, which comes with bile from the liver. Normally, traces of urobilinogen are found in the urine. Their complete absence indicates a violation of the flow of bile into the intestines.

Ketone bodies are absent normally and appear with an increase in their concentration in the blood.

Microscopic examination of urine sediment:

There are organized (erythrocytes, leukocytes, epithelium and cylinders) and unorganized sediment (various salts).

Red blood cells in the urine of healthy people are absent or rare. They do not pass through the glomerular filter and appear in the urine during pathological processes in the kidneys and/or urinary tract.

Leukocytes absent or single in the field of view. (more than 5 leukocytes per field of view) can be aseptic and infectious.

Epithelial cells There may be single ones in the field of view, heard from different parts of the urinary tract: flat (urethra), transitional (pelvis, ureter, bladder). Renal (tubular) epithelium is normally absent. By increasing a certain type of cell, the localization of the pathological process is determined.

Cylinders – These are casts of the renal tubules with cellular or protein composition. Hyaline casts, composed of protein, may be present normally after exercise. Cell casts always indicate the presence of pathology.

Bacteria normally absent, but bacteriuria does not always indicate an inflammatory process; the number of bacteria is of primary importance.

Salt. The appearance of crystals of various salts in the urine indicates a change in the urine reaction. Normally, only oxalates and amorphous urates may be present in small quantities.

Normal indicators of general clinical urine analysis in pregnant women:

Index	Characteristic or meaning
Quantity	150 – 200 ml
Color	Straw to amber yellow
Transparency	Full
Density	1.010 – 1.030
PH	5.0 – 7.0
Protein	Up to 0.033 g/l
Glucose	Absent
Bilirubin	Absent
Urobilinogen	Footprints
Ketone bodies	None
Red blood cells	1 – 2 in field of view
Leukocytes	Up to 5 in sight
Epithelium	Single cells of transitional and squamous epithelium in the field of view
Cylinders	Single hyaline casts in the field of view
Salts	Single amorphous urates and oxalates

Additionally If there are changes in the urine test, a repeat test is first prescribed for confirmation, and then additional examination methods are prescribed.

Additional tests (if indicated)

Urinalysis according to Nechiporenko allows you to study the cellular composition of urine in more detail. This study is prescribed:

• with changes in the general urine analysis (appearance of a large number of red blood cells, leukocytes, casts),
• If you have symptoms of kidney disease,
• As a treatment control.

Table: normal indicators:

The most common reasons for increased performance:

Red blood cells:

• Urolithiasis disease;
• Glomerulonephritis;
• Polycystic kidney disease;
• Complicated pyelonephritis;
• Urinary tract infection;
• Malignant hypertension;
• Systemic diseases (systemic lupus erythematosus, vasculitis, collagenosis).

Leukocytes:

• Cystitis;
• Glomerulonephritis;
• Fever of any origin.

Cylinders:

• Preeclampsia, Eclampsia;
• Acute renal failure;
• Glomerulonephritis;
• Pyelonephritis;
• Nephropathy of pregnancy;
• Intense physical activity.

Urine analysis according to Zimnitsky allows you to assess the concentration ability of the kidneys. The study is prescribed for kidney diseases, systemic diseases, complications of pregnancy (severe toxicosis, gestosis, nephropathy).

To do this, you need to collect urine every three hours in different containers. Three hours before the start of collection, you must completely empty your bladder. You also need to record the amount of all liquid consumed. The study evaluates:

• The amount of urine and its density in each portion. Normally, the change in volume can range from 40 to 350 ml. The difference between the maximum and minimum density indicators must be at least 0.012 – 0.015 (for example, 0.015 – 0.028);
• The total amount of urine excreted per day is normally 70–80% of the fluid consumed;
• The ratio of daytime and nighttime diuresis. The amount of daily urine averages 60–70% of the daily volume.

Determination of daily diuresis gives an idea of ​​the fluid consumed and excreted from the body. A simpler and more economical method compared to the Zimnitsky analysis, when you simply need to determine whether fluid is accumulating in the body. You just need to measure the amount of all urine per day and write it down along with the amount of liquid you drink and the vegetables, fruits and liquid portion of soups consumed. The normal water balance is 70-80%. Analysis is prescribed when edema occurs in pregnant women and in the treatment of gestosis.

Urine analysis for glucosuric profile carried out when glucose is detected in a general urine test and in the presence of diabetes mellitus. For the study, daily urine is collected in three jars: from 8:00 to 14:00 you need to urinate in the first jar, from 14:00 to 22:00 in the second and from 22:00 to 8:00 in the third. The total amount of glucose excreted per day is determined.

Bacteriological culture of urine (bacteriological culture) carried out to identify and identify pathogens of diseases of the urinary system, as well as determine their sensitivity to antibiotics. To do this, urine is placed on a nutrient medium (agar, sugar broth) and the growth of microorganisms is observed. Indications:

• Urinary tract infections;
• Monitoring the treatment;
• Asymptomatic bacteriuria in pregnant women;
• Diabetes;
• Immunodeficiency;
• Suspicion of antibiotic-resistant flora.

For the study, an average portion of morning urine (3–5 ml) is taken, collected in a sterile container.

Physiological changes in the urinary system during pregnancy

During pregnancy, a woman’s kidneys work in an intensive mode, removing from the body not only the products of their metabolism, but also the products of the fetus’s metabolism. That is why frequent and careful monitoring of changes in the quality, quantity of urine and its cellular composition is necessary.

In the first trimester of pregnancy, renal blood flow increases and gradually decreases thereafter, which allows other organs to receive additional blood volume. Glomerular filtration increases, and tubular reabsorption does not change throughout pregnancy, this contributes to fluid retention in the body, which manifests itself as pastyness on the legs at the end of pregnancy.

As the uterus grows, the location of adjacent organs changes. Towards the end of pregnancy, the bladder moves upward beyond the boundaries of the small pelvis, its walls hypertrophy to resist compression by the uterus. Sometimes the development of hydroureter can be observed (impaired patency of the ureter and, as a result, accumulation of urine in it), which occurs more often on the right. The reason is that the pregnant uterus turns slightly to the right, pressing the ureter against the innominate line of the pelvic bone.

Under the influence of hormones (mostly progesterone), the urinary tract expands and decreases tone, which contributes to the development of infection during pregnancy (pyelonephritis).

As a rule, the indicators in any urine tests in pregnant and non-pregnant healthy women are practically the same. A general urine test is taken to determine any abnormalities during pregnancy and should accompany every visit to the doctor at all stages of pregnancy. Urinalysis is a mandatory step in prenatal diagnosis.

Color and transparency

The slightest cloudiness indicates a deviation from the norm and may indicate the presence of urolithiasis, salts, bacteria, leukocytes, and other formed elements.

Urine reaction (pH)

A decrease in the pH value of a pregnant woman’s urine indicates severe early toxicosis or food poisoning, which is accompanied by vomiting, diarrhea, i.e., loss of fluid from the body. A decrease in pH also occurs with a lack of potassium and magnesium in the body.

Protein in urine

More than 300 mg (proteinuria) per day of protein in the urine of a pregnant woman indicates kidney disease. During pregnancy, exacerbation of chronic kidney diseases may occur. If the protein is present in high titers, it means that the pregnant woman has developed one of the dangerous conditions: pyelonephritis or gestosis (late toxicosis). Proteinuria in pregnant women at 32 weeks indicates the development of nephropathy.

Glucose (sugar) in urine

If the level of sugar in the urine remains consistently high, then we are most likely talking about prediabetes or diabetes mellitus. To confirm (refute) the diagnosis, you need to donate blood for sugar and undergo a glucose tolerance test.

Ketone bodies in urine

Ketone bodies in urine during pregnancy indicate early toxicosis.

Red blood cells in urine

Their presence can be a sign of many diseases of the urinary system and gynecological pathology and requires a detailed in-depth examination.

Leukocytes in urine

A slight excess of the norm (leukocyturia) - up to 10-20 in the field of view, may be the result of low-grade inflammation or insufficiently thorough treatment (washing) of the external genitalia before taking tests. Leukocyturia with an increase in leukocytes to 40 or more in the field of view during pregnancy is a sign of pyelonephritis and other infectious kidney diseases.

Phosphates in urine

An increase in salts in the urine of a pregnant woman is a sign of disorders in the genitourinary system of the expectant mother.

Bacteriuria (presence of bacteria in urine)

Bacteriuria (the presence of bacteria in the urine) in pregnant women is evidence of cystitis or kidney disease. The appearance of bacteria together with an increase in leukocytes indicates a disease of an infectious nature. Most often this is a sign of acute pyelonephritis. Escherichia coli (Escherihia coli) is usually found in the urine of pregnant women. In order for treatment to give the expected effect, urine culture must be carried out for flora and sensitivity to antibiotics.

Norms

Norm
Color and transparency	The color of urine should be yellow with varying shades ranging from light to dark (but not brown). The color intensity varies depending on factors such as coloring foods (beets, blackberries, red berries), synthetic drugs, as well as vitamin complexes and contrast agents. Transparency must be complete.
Reaction (pH)	Depends on the nature of the diet. Normally, when eating meat foods, an acidic urine reaction will be observed; when eating a vegetarian or dairy diet, the urine reaction will be alkaline.
Protein	May be present in traces (up to 0.1 g/l). Sometimes protein in the urine of pregnant women can be a consequence of intense physical activity, anxiety and stress.
Glucose (sugar)	May appear in small quantities during the second half of pregnancy. Normally, these numbers are insignificant and do not cause concern.
Red blood cells
Leukocytes	Normally, they should be within the following limits: general urine test - 6-8 in the field of view; urine analysis according to Nechiporenko - no more than 2000 per 1 ml.
Phosphates	Normally, they decrease sharply, since a significant part of phosphoric acid compounds goes to the formation of fetal skeletal bones, and after childbirth - to the formation of milk.

Urine analysis during pregnancy

The kidneys are a biological filter for all substances dissolved in the blood. They remove excess liquid, salts, toxic and waste substances. Therefore, monitoring kidney function during pregnancy is one of the most important tasks. To do this, regular urine tests are performed.

A general urine test is taken before each visit to an obstetrician-gynecologist at the clinic; additionally, other urine tests are performed as prescribed by the doctor. This is necessary in order to promptly identify abnormalities in the functioning of the kidneys, the inflammatory process, and the development of preeclampsia.

Urine during pregnancy.

In a urine test during pregnancy, the doctor will evaluate both physical and chemical indicators - color, clarity, presence of sediment, density (specific gravity) and pH, and inorganic urine sediment - the amount of formed elements, salts, microbes, protein.

The acidity or pH of urine will depend on diet: with a predominantly plant-and-dairy diet, the urine will be slightly alkaline, and with an abundance of meat, it will be acidic. The specific gravity of urine indicates the degree of dissolution of salts and other substances (glucose, protein) in it. A sharp increase in specific gravity may indicate impaired renal function or the presence of serious diseases (diabetes, nephropathy).

How to donate urine during pregnancy.

The result can significantly depend on the quality of urine collection for analysis during pregnancy. Before donating urine, you should not eat highly coloring or diuretic foods (watermelons, melons, cucumbers), drink coffee, or take medications that can affect the composition of urine.

Urine for general analysis is collected in the morning, immediately after sleep, after thoroughly washing the external genitalia with soap. Pee into a sterile cup or jar: only a medium portion is needed, approximately 30-50 ml. It must be brought to the laboratory within one to two hours to avoid distorting the results.

Main indicators and possible deviations from the norm in the analysis

Let's look at the main indicators of urine analysis.

Acetone in urine during pregnancy.

The acidity of urine changes during toxicosis with vomiting, causing both acidification of the urine and its alkalization, depending on the measures taken and the severity of vomiting. One of the signs of toxicosis and its fairly pronounced condition is the appearance of acetone (ketone bodies) in the urine. They change the pH of urine to the acidic side.

Cloudy urine during pregnancy.

If the clarity of urine is impaired, one may suspect the presence of mucus, microbes or leukocytes, or protein in it, which indicates a serious inflammatory process in the kidneys or urinary system. The appearance of sediment may indicate urolithiasis or metabolic disorders.

Protein in urine during pregnancy.

One particularly alarming indicator in the urine of pregnant women is protein. In a healthy woman, it should normally be absent, but during pregnancy, especially in its later stages, traces of protein in the urine, determined by machines, are quite acceptable. They are designated in the analysis form by the term “trace”. These are features of the blood circulation of the kidneys and the result of increasing loads on them.

An increase in the amount of protein in a general urine test serves as a signal for a more detailed examination of the woman and a urine test for daily protein levels. An increase in protein levels above 300 ml (0.033 hl) may indicate the development of a serious pregnancy complication - nephropathy or gestosis. Also, the appearance of protein in the urine can be a sign of infectious and inflammatory kidney diseases - glomerulonephritis, nephrosonephritis. In such conditions, immediate hospitalization in a hospital, comprehensive examination and treatment is necessary, and if the pregnancy is more than 32 weeks and progressive deterioration of kidney function, early delivery is required to save the life of the child and mother. Nephropathy leads to increased blood pressure and the development of dangerous complications in the form of preeclampsia and eclampsia, which can dramatically disrupt the nutrition of the placenta, cause convulsions in the mother and death of the fetus.

Bacteria in urine during pregnancy.

During pregnancy, bacteria are often detected in a general urine test in women. This phenomenon is quite common and is due to the structural features of the genitourinary system of women, proximity to the genitals of the rectum and weakening during pregnancy of the immune defense of the mucous membranes from microbial attacks. The appearance of microbes in the urine may be a defect in urine collection and a consequence of insufficient hygiene of the genital organs, or it may be a symptom of a serious urinary tract infection - pyelonephritis, cystitis. Escherichia coli or staphylococcus are especially common in urine.

A separate option could be asymptomatic bacteriuria: the appearance of microbes in the urine in the complete absence of signs of inflammation from the genitourinary tract. This condition requires close monitoring by a doctor, as it may be the initial stage of serious kidney and bladder infections. Asymptomatic bacteriuria with a large number of microbial bodies in a milliliter of urine can lead to premature birth, threatened miscarriage, intrauterine infection of the fetus, and other complications.

If microbes are detected in a general urine test, additional urine culture is performed during pregnancy. This analysis is carried out according to general rules, but urine is collected in a sterile cup and sown on special media, detecting the number and type of microbes in the urine, as well as determining the sensitivity of these microbes to antibiotics.

Leukocytes in urine during pregnancy.

The presence of leukocytes in the urine indicates an inflammatory process in the genitourinary system. Depending on the type and number of leukocytes, the level of damage to the urinary system can be suspected. These may be the kidneys or the renal pyelocaliceal system, the ureters and bladder, and the urethra. When there are a large number of leukocytes in the urine, visible to the eye as lumps of mucus and flakes, they speak of pyuria (pus in the urine). This is accompanied by a serious condition for the pregnant woman, and is extremely dangerous for the fetus - it can threaten intrauterine death, premature birth, fetal hypoxia, and placental problems.

Red blood cells in urine during pregnancy.

The appearance of red blood cells in the urine is an unfavorable symptom, since Normally, they should be completely absent in a pregnant woman.. Blood in the urine can manifest itself as microhematuria, that is, a very small number of red blood cells. This happens with cystitis, urolithiasis, pyelitis, and in the initial stage of gestosis. Sometimes blood in the urine is visible to the naked eye, which is called gross hematuria or “meat-slop-colored urine.” This occurs with nephritis, glomerunonephritis with nephrotic syndrome, with severe gestosis. These conditions are extremely dangerous for the mother and fetus and require immediate hospitalization and active therapy, and sometimes an emergency caesarean section to save the baby and the mother herself.

Sugar in urine during pregnancy

If diabetes mellitus or gestational diabetes is suspected, the level of glucose (sugar) in the urine is determined. When carbohydrate metabolism is disturbed, associated both with pregnancy itself and with the onset of diabetes, as a result of an increase in the level of glucose in the blood, its excess is filtered into the urine. Typically, an increase in sugar levels is accompanied by an increase in the density of urine, a sharp increase in the volume of urine excreted (up to three to five liters) and severe thirst.

Bad urine during pregnancy.

There are a number of conditions, the manifestation of which requires immediate consultation with a doctor or calling an ambulance. First of all this:

• acute decrease in the amount of urine up to its retention for more than 8-12 hours;
• the appearance of blood in the urine;
• severe turbidity of urine with fever, lower back pain, general malaise;
• cloudy urine combined with high blood pressure, double vision and swelling;
• passing large quantities of urine with great thirst, weakness and malaise.

• slime

How to correctly collect urine for analysis?

It is necessary to collect an average portion of morning (immediately after sleep) urine in a special sterile container for analysis with a plastic lid.

On the eve of sampling, avoid taking medications (vitamins, diuretics, hormonals, antibiotics and other medications) and coloring foods (carrots, beets, asparagus, cranberries, blueberries, etc.).

The last sexual intercourse should be at least 12 hours before collecting the urine sample.

First of all, before collecting urine, it is necessary to thoroughly clean the external genitalia. To prevent vaginal fluid from getting into the urine sample, it is necessary to cover the vaginal opening with a piece of cotton wool or insert a tampon. Try not to touch the urine collection container with your body.

When urinating, flush the first portion of urine (1-2 seconds) into the toilet, and then, without interrupting urination, collect the second portion of urine, stopping at the end of the process and finishing urinating into the toilet. For analysis you will need about 50 ml of biomaterial.

The collected urine must be delivered to the laboratory within 1-1.5 hours. On the jar with the analysis, clearly indicate your last name, initials, date of collection of the analysis and time.

Interpretation of urine analysis during pregnancy

Laboratory research of this biological fluid includes the determination of its organoleptic characteristics, physicochemical properties, biochemical composition and sediment microscopy.

Standards for general urine analysis during pregnancy

In a healthy person, urine can range in color from straw to deep yellow. Often, pregnant women experience bright yellow or orange urine, which is due to taking vitamins on the eve of the test.

When drinking heavily, the urine becomes diluted and becomes colorless, and, conversely, when drinking a small amount of liquid or when it is lost (vomiting, diarrhea), the urine becomes more concentrated, dark yellow.

A sign of the disease is most often considered if the urine has the following color:

• strong tea (“beer” color) – pathology of the liver and gall bladder, for example, parenchymal (liver) jaundice or viral hepatitis;
• pink-red (the color of “meat slop”) – inflammation of the kidneys, for example, acute glomerulonephritis;
• greenish-yellow (“lemon” color) – obstructive jaundice (i.e. cholelithiasis), the presence or entry of pus into the urinary system;
• dark brown (dark brown) – hemolytic anemia;
• whitish – the presence of large amounts of phosphates or lipids, for example, renal lymphostasis, fatty degeneration of the kidneys;
• milk – urinary tract infection, cystitis, pyelonephritis.

Freshly collected normal urine is ideally clear, perhaps slightly cloudy due to the presence of epithelium and mucus.

It also becomes slightly cloudy due to the sample standing for a long time, so the collected sample must be delivered to the laboratory as soon as possible so as not to distort the analysis result. A small amount of water drunk can also cause cloudy urine in a healthy person.

Severe cloudiness of urine is caused by red blood cells, white blood cells, bacteria, mucus, a significant amount of salts or epithelial cells, etc.

This indicator depends on the amount of substances dissolved in the urine and the water drunk per day.

The relative density (or specific gravity) of the urine of a healthy person is 1,003-1,035 g/l.

An increase in density occurs with dehydration, toxicosis, uncontrolled diabetes mellitus, glomerulonephritis, etc., and a decrease occurs with heavy drinking, nephritis, and renal failure.

The urine reaction in humans ranges from 5.0 (acidic) to 8.0 (slightly alkaline) depending on diet. The acidity of urine is increased by protein (in particular, meat) foods and fats, and alkalization of urine is promoted by plant foods (fruits, vegetables) and dairy foods.

The urine reaction in a healthy person with a balanced diet is slightly acidic (pH = 6.0 and >) or neutral (pH = 7.0).

An acidic environment is a good environment for the development of bacteria, so having such an environment constantly is undesirable.

Kidney failure, urinary tract infections and other diseases affect the increase in pH.

Diabetes mellitus, tuberculosis, fever, severe diarrhea and other ailments will affect the pH by reducing it.

Normally, there is no protein in the urine, but during pregnancy a slight increase to 0.033 g/l is allowed, which is caused by strong emotional concerns for the health of the fetus, possible overheating in the summer or hypothermia in the cold season, ingestion of undenatured protein foods (raw eggs and homemade unboiled milk ), the presence of allergies at the time of the test, and in general, a strong load on the kidneys.

Towards the end of the second trimester, a small amount of protein may appear due to mechanical compression of the kidneys by the pregnant growing uterus, but this phenomenon is not permanent and is harmless only in the absence of other signs of kidney disease.

Also, protein can get into the urine along with vaginal secretions; therefore, in order for the analysis result to be as accurate as possible, it is necessary to follow all the rules for collecting a urine sample.

The appearance of protein (proteinuria) indicates diseases of the kidneys (pyelonephritis, glomerulonephritis, nephropathy of pregnancy, etc.), urinary tract (cystitis, ureteritis) or gestosis (late toxicosis).

Normally, sugar in the urine of a healthy person is absent or found in small quantities up to 0.083 mmol/l.

During pregnancy, “traces” of glucose may be found in the urine. This happens due to heredity (especially during late pregnancy - after 35 years), obesity, consumption of high-carbohydrate foods or severe stress.

In the second trimester of pregnancy, physiological glucosuria is observed, which is caused by normal processes occurring in the body of a pregnant woman. It does not require drug treatment, but nutrition should be adjusted towards reducing the amount of carbohydrate foods in the pregnant woman’s diet (limit the consumption of sweets and starchy foods).

Detection of glucose (glucosuria) is observed in diabetes mellitus, renal and other types of diabetes.

In a healthy person, bilirubin is not detected in the urine. But with obstructive jaundice, viral hepatitis and other diseases that cause difficulty in the outflow of bile, the appearance of bilirubin is observed, and the urine turns dark, “the color of beer.”

During pregnancy, these bodies can be detected in the urine, which indicates dehydration due to early toxicosis. But this is not a trifle, ketone bodies poison the body with acetone, so it is necessary to be examined to exclude other possible diseases (in particular, diabetes).

Acetone is most often found in urine in cases of anemia or gestational diabetes in pregnant women. In such cases, the hospital doctor prescribes an IV and a special diet. The main goal is to drink more alkaline mineral water (Borjomi, for example), eliminate sweets and fatty foods, reduce protein intake, and vice versa, include more carbohydrate foods in the diet.

They are not found in the urine of a healthy person. A positive result indicates the presence of an infection in the urinary tract.

Normally, there is no hemoglobin in the urine. Usually its presence indicates hemolytic anemia.

In a healthy person, there are either no red blood cells in the urine, or 1-2 cells are detected in the field of view.

An increase in the number of red blood cells (hematuria) occurs in kidney diseases and diseases of the urinary system.

To combat pathogens of various diseases, the body produces leukocytes. Normally, a woman’s urine contains 0-5 leukocytes per field of view.

An increased content of leukocytes (leukocyturia) always indicates inflammatory processes in the kidneys - pyelonephritis, urinary tract - cystitis, urethritis or genital organs.

Women who neglect personal hygiene and other rules when taking the test receive false positive results.

An excessive increase in white blood cells (pyuria) can be detected even with the naked eye: the urine is cloudy, with “flakes” and “threads” floating in it. This indicates that purulent is joining the inflammatory process.

Epithelial cells

Epithelium lines the mucous membrane of all internal organs. Flat epithelium is almost always present in the urine sediment of a healthy person in an amount of up to 3 cells per field of view. Their numbers increase with urinary tract infections.

Another type of cell, transitional epithelium, appears in the urine with cystitis, pyelonephritis, and kidney stones. The presence of 1 transitional epithelial cell in the field of view is acceptable.

The renal epithelium is found in the sediment when there is an infectious lesion of the kidney parenchyma - pyelonephritis, glomeruli of the kidneys - glomerulonephritis, etc. In a healthy person, the renal epithelium is absent in the urine sediment.

In case of kidney diseases, protein accumulates in the renal tubules, and leukocytes, red blood cells, exfoliated epithelial cells and other particles “stick” to it. This plastic mass envelops the cylindrical tubules from the inside, and thus makes, as it were, a cast of them. When urinating, these cylindrical casts are washed out and identified by the laboratory assistant during analysis.

Since protein and other elements are excreted in the urine only in the pathological condition of the kidneys, then in a healthy person there should be no casts in the sample; only hyaline casts can be detected and no more than 1-2 in the field of view, an increased content of this type or the presence of others (granular , waxy, erythrocyte, leukocyte, epithelial) is possible only with various renal diseases.

Bacteria and fungi

In the analysis of a healthy person, bacteria and fungi should be absent; their presence indicates an infection of the genitourinary system (cystitis, urethritis, candidiasis, etc.).

Urine is an aqueous solution of the breakdown products of protein substances and various salts that precipitate. The presence of a certain type of salt crystals in the urine indicates a change in pH in one direction or another. An acidic environment causes the formation of urates, an alkaline environment causes the formation of phosphates. If other urine parameters are normal, the presence of salts is not considered a sign of any disease.

Excessive salt content (urates, phosphates or oxalates) leads to the appearance of stones and, as a consequence, to the development of urolithiasis.

This happens due to metabolic disorders and unbalanced nutrition.

Precipitation of urates occurs when the body is dehydrated (for example, during a hot period and insufficient drinking regimen, due to excessive vomiting, diarrhea, etc.) or when meat foods predominate in the diet.

Phosphates appear when consuming foods rich in phosphorus (fish, fermented milk, oatmeal, buckwheat, etc.).

Oxalates occur at any pH reaction, but with excessive consumption of foods containing large amounts of oxalic acid.

Slime The inner lining of the organs of the urinary system constantly secretes mucus. Normally, mucus is absent or found in small quantities.

Increased mucus secretion indicates insufficient hygiene of the genital organs during analysis or an inflammatory disease of the urinary system, but in the presence of other signs of pathology.

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Of all types of diagnostics, urine analysis during pregnancy plays a primary role. If you look at the calendar of tests that pregnant women have to undergo, you can see that the most frequent, regular test is a urine test. A woman receives an appointment for this test every time she visits a gynecologist.

During the normal course of gestation (pregnancy), the expectant mother should visit the gynecologist about twenty times. Thus, on average, she will need to take twenty urine tests during her current pregnancy. This, we note, is only subject to normal gestation! In cases where there are deviations in laboratory diagnostic results, there may be more such tests. There are also special types of urine tests that are prescribed separately, for example, the “Zimnitsky test”.

Urine

In Latin, urine is called urina (urina) - this is a type of secretion (excrement) of living organisms, formed in the process of their life.

The kidneys, while performing the function of cleaning the blood from substances unnecessary for the body, filter the blood plasma. As a result of their work, so-called primary urine is formed. This fluid is reabsorbed into “secondary urine”, which is excreted from the kidneys through the ureter into the bladder and from there through the urethra to the outside.

Analysis of urine

A general urine test can tell a gynecologist a lot about the patient’s health. For example, it can show pregnancy, although there are not many cases in which a doctor specifically prescribes a urine test for pregnancy. To determine pregnancy, it is customary to use other types of diagnostics - a blood test or a home test (expectant mothers call it a “pregnancy test”). Determination of pregnancy based on the results of a urine test is possible due to an increase in the content of the hormone hCG (pregnancy hormone) in it. The rest of the tests work on the same principle.

Urine collection rules

Morning urine is used for laboratory testing. It is believed that urine, which collects in the bladder during sleep, is more suitable for obtaining objective data about the patient’s health.

Urine should be collected in special factory-made containers, which are sold at any pharmacy. The advantage of these containers over any other is obvious - their sterility is guaranteed by the manufacturer, which cannot be said about the various jars and flasks that are available in abundance in the household.

In total, about 50 ml of liquid will be needed for analysis. It is necessary to collect urine that flows out at the end of urination. To isolate urine from the vaginal environment, you need to use a cotton swab. You must write your data legibly on the container – first name, last name, date of birth. Thanks to these simple steps, you can avoid possible confusion with other people's tests.

The container must be transported in such a way that it is kept warm. Low temperature, and this will be considered an air temperature below 10 ° C, affects the urine, causing sediment. Sediment is a parameter in the clinical study of urine, and therefore it can be incorrectly interpreted as an indicator of renal failure in a pregnant woman.

On the eve of urine collection - at least 12 hours before the procedure - you must refrain from taking medications (vitamins, antibiotics, steroids) and foods that can change the color of urine, such as beets or blueberries.

During urine collection, genital hygiene is important; any dirt can affect the analysis parameters. You need to avoid sexual intercourse at least 10 hours before urine collection.

Types of urine tests

In medical clinical practice, there are different urine tests: general urine test, Nechiporenko test, Sulkovich test and Zimnitsky test. Some of them are needed during gestational monitoring, and some are not. In any case, you need to know about them in order to understand what specific type of urine test was prescribed during pregnancy and what it is needed for.

General urine test (clinical urine test)

The most informative and most common type of urine analysis in medical practice is clinical urine analysis.

It includes organoleptic (quantity, color, foaminess, transparency, smell), physicochemical (density, acidity) and biochemical (protein) studies, as well as microbiological (detection of gram-positive and gram-negative bacteria, fungal infections) examination and microscopic examination of urinary sediment (organized and unorganized types of sediment, cylindruria).

Urinalysis according to Nechiporenko (Nechiporenko test)

This type of laboratory test is focused exclusively on identifying leukocytes, red blood cells and casts in urine. The sediment content is estimated in relation to 1 ml of urine. The analysis is carried out to identify infectious invasions of the genitourinary system, check the functions of the kidneys, urethra, and bladder.

This type of diagnosis is used during monitoring of gestation in cases where general clinical analysis showed deviations from the norm, indicating the presence of infection. The function of the Nechiporenko test in this case is to give a more complete clinical picture of what is happening in the woman’s body. This test is also prescribed when there is a suspicion of inflammation of the genitourinary system.

Analysis standards according to Nechiporenko:

Urine analysis according to Sulkovich (Sulkovich test)

This type of clinical trial is not aimed only at pregnant women, its primary target is newborns and young children, and rarely adult patients. Considering that pregnancy will not last forever, a young mother will probably be interested to know what awaits her newborn child after birth.

Using the Sulkowicz test, the amount of calcium in urine is determined. A deficiency or excess of this microelement in a child’s body will indicate the presence of certain pathologies or an incorrectly structured diet. The Sulkowicz test is often used to accurately calculate the dosage of vitamin D for infants.

Urine analysis according to Zimnitsky (Zimnitsky test)

Zimnitsky's test is a type of diagnosis, the purpose of which is to obtain information about the throughput and concentration capacity of the kidneys, i.e. how many liters of urine can pass through the kidneys in one day. Using this type of analysis, the potential of the urine dilution function is also assessed (in the kidneys, using the phenomenon of osmosis, urine is divided into primary and secondary urine, if there are many useful substances in the secondary urine, this indicates poor performance of the dilution function).

The analysis is used to diagnose pregnant women in cases where the attending physician needs to clarify the patient’s clinical condition.

A normal analysis indicator is the complete absence of glucose and polypeptides in urine. If they are present in a woman’s body, in her genitourinary system, then this will be evidence of an inflammatory process.

Bacteriological urine analysis (urine culture)

During a routine clinical analysis of urine, a laboratory assistant examines the sediment microscopy. If bacteria and fungi are found in concentrations higher than normal, then the conclusion will indicate bacteriuria. Such an indicator will inevitably mean the need for a more in-depth study aimed at specifically identifying microorganisms found in the sediment - LHC urine culture.

LHC urine culture is required during gestation. It is prescribed twice - at 9-12 weeks, after the woman has been able to become pregnant, and at 35-36 weeks, i.e. in the first days of the ninth month. Of course, if a woman has an infection, then a bacterial urine test may be performed more often.

The interpretation of the examination result depends on the readings of other tests - general blood and urine tests, as well as on the type of pathogen, the general condition of the body and the presence of toxicosis. The norm for bacterial urine analysis during pregnancy is almost the same as for a person in normal condition:

• Less than 1000 CFU/ml (colony-forming units per 1 ml) – the result is negative (no infection).
• More than 1000 CFU/ml, but less than 10,000 CFU/ml – the result is questionable, a re-examination is prescribed.
• More than 10,000 CFU/ml – the result is positive (there is an infection).

Explanation of the results of clinical urine analysis in pregnant women

We will give an interpretation of the results of a clinical urine test in pregnant women using a table that displays typical indicators for a healthy woman.

Indicators	Values
Amount of urine	1500-2000 ml
Color	Straw yellow, amber yellow
Transparency	Full
Density	1,010-1,030
PH	5,0-7,0
Protein	Up to 0.033 g/l
Glucose	Absent
Bilirubin	Absent
Urobilinogen	Footprints
Ketone bodies	None
Red blood cells	1-2 in point of view
Leukocytes	Up to 5 in p.z.
Epithelium	Single cells of squamous and transitional epithelium
Cylinders	Single hyaline casts
Salts	Single urates and oxalates

For an in-depth understanding, a more complete explanation of the parameters of urine analysis during pregnancy will be given below.

Amount of urine

The process of urine excretion in a certain unit of time is called “diuresis” in medicine. There are daily, daytime and nighttime types of diuresis. In a person in normal condition, it corresponds to 70-80% of the liquid drunk. The norm of liquid consumption is 1.5-2 liters. In pregnant women, this figure is normally increased by a quarter. This is due to more intensive work of the kidneys.

Color

The color of urine is an important indicator of a person’s health. Diagnosing the color of urine in an ordinary person is no different from diagnosing the color of urine in a pregnant woman. A more deciphered urine color parameter in this video:

Transparency

Urine should normally be clear. If it is cloudy, you need to find out the cause of the cloudiness - bacteria, red blood cells, fat, mucus, salts or protein suspension. To do this, additional research is carried out - the urine is heated and shaken; add alkali and acetic acid to urine; examine urine under a microscope.

Density

This parameter is directly dependent on the liquid a woman drinks per day and, in general, on the content of various dissolved substances in the urine.

The normal urine density indicator for a pregnant woman is 1004-1034 g/l.

High density will indicate dehydration. The cause of dehydration may be glomerulonephritis, toxicosis, diabetes mellitus.

PH

The pH value of urine ranges from 5.2 (acidic) to 8.2 (slightly alkaline). A low pH (acidic environment) creates good conditions for the development of bacteria and is therefore undesirable.

Protein

In a normal person, protein should be absent from urine; in pregnant women, a small amount of it is acceptable - up to 0.034 g/l.

A protein higher than the specified value will be possible evidence of an infectious lesion of the genitourinary system or severe toxicosis.

Glucose

During pregnancy, the blood glucose level ranges from 3.2 to 5.4 mmol/l. A value below the lower threshold is hypoglycemia, above the upper threshold is hyperglycemia.

It is important for pregnant women to monitor their blood glucose levels, as the risk of gestational diabetes increases in the third trimester of pregnancy.

Bilirubin and urobilinogen

A healthy woman should not have these substances in her urine. Their presence is a signal that there are problems with the liver - the higher the concentration of these substances, the greater the problem.

During the anxious period of pregnancy, most organs and systems of the female body are amenable to global restructuring. Kidneys occupy one of the first places in this process. During pregnancy, there is an increase in kidney size by 2 cm, dilation of the ureters, increased renal blood flow and physiological hydronephrosis. This directly affects urine levels during pregnancy. Therefore, you need to know what to be wary of, and what deviations in indicators are considered physiological characteristics during pregnancy.

For nine months, even a completely healthy woman is registered with a doctor to monitor the progress of her pregnancy. A general urine test (clinical) during pregnancy is prescribed for regular monitoring of kidney function, as well as for timely diagnosis of infections or inflammations in the genitourinary system. Starting from the first days after fertilization of the egg, a woman may notice a frequent urge to go to the toilet, a slight change in the color and smell of urine. These are absolutely normal changes, since salt compounds, enzymes, iodine, sugar and other elements are excreted in the urine. Based on the results of a general analysis, it is possible to promptly suspect diseases of the heart, gastrointestinal tract and metabolic disorders. As a rule, you have to give urine once every four weeks during pregnancy. If there are deviations or obvious diseases, control urine testing is prescribed twice a month.

Important! It is necessary to pay attention to the flow of urine during pregnancy; if it is disturbed, complications may arise.

How to correctly collect material for a general urine test during pregnancy?

In order for laboratory results to be reliable, you need to properly prepare for urine collection. Often women neglect basic recommendations and as a result they end up with bad tests.

Rules for collecting urine for clinical analysis:

1. 24 hours before diagnosis, exclude coloring foods from your diet (vitamins, beets, blueberries, tomato juice), as this may make it difficult to determine the “color” of urine. In addition, avoid fried and pickled foods.
2. Avoid physical activity and sexual intercourse 10-18 hours before taking the sample to prevent overdiagnosis. They promote the appearance of protein in the urine.
3. If your health allows, doctors advise skipping one dose of a diuretic before taking a urine test.
4. To collect urine, buy a special container from a pharmacy. It is sterile and closes tightly. You can take a homemade glass jar and sterilize it yourself, but this is not very convenient and often leads to repeated analysis. Don't forget to include your details on the urine containers.
5. A special place is occupied by hygiene of the genital organs. Immediately after waking up, you need to take a shower or wash yourself thoroughly. Women in late pregnancy experience vaginal discharge. If they are abundant, then use a gauze pad to prevent them from getting into the urine.
6. For a general analysis, an “average portion” of morning urine is taken in a volume of 100-150 ml. How to do this: flush the first portion of urine into the toilet for two seconds, then the main part into the container and the rest of the urine back into the toilet.
7. The container with urine should not be shaken and should not be stored for a long time. The optimal delivery time to the laboratory assistant is 1.5-2 hours.

Basic urine indicators during pregnancy: what do they mean?

Having taken urine for diagnostics, the laboratory technician determines physicochemical, microbiological and organoleptic indicators.

Physical parameters of urine

Color (COL). The normal color is bright yellow to straw-colored. But this indicator is affected not only by any disease, but also by the food you ate and the amount of liquid you drank. For example, a bright orange color can be caused by taking multivitamin complexes, and a dark yellow color can be caused by a lack of sufficient drinking.

But there are certain changes in the color of urine during pregnancy that indicate trouble in the health of the pregnant woman:

• “tea” or “beer” color - damage to the liver or gall bladder;
• the color of “meat slop” - pathological processes in the urinary system;
• yellow-green color - purulent inflammation in the kidneys;
• brown color - hemolytic anemia;
• cloudy white color - high concentration of phosphates or lipids (degenerative obesity of the kidneys);
• light yellow (straw) urine - cystitis, pyelonephritis.

Specific Gravity (SG). The relative density varies from 1003 to 1035 g/l. The variability of the indicator is due to the amount of compounds that dissolve in the urine and the volume of fluid drunk.

Density is increased during acute dehydration, if a woman, for example, has toxicosis or latent diabetes. Reduced levels indicate kidney failure, hormonal imbalances or excessive water consumption.

A multiple increase in the limiting norm of density is a sign of hypersthenuria. This condition causes large amounts of glucose or protein in the urine and difficulty urinating.

Transparency (CLA). Opposite such a column in the analysis form should ideally be “transparent”. If a woman has cloudy urine during pregnancy, this indicates an admixture of leukocytes, epithelium, protein, blood and even pus. This result requires the exclusion/confirmation of kidney inflammation.

Chemical parameters of urine

pH reaction. The acidity of urine directly depends on proper nutrition. Normal pH ranges from 5.0 to 7.0. Increased acidity levels are promoted by high consumption of animal fats and proteins, as well as nuts and foods containing thermally processed sugar. An alkaline reaction is provided by fruits and vegetables, some grains, and natural honey. The more acidic the urine, the more favorable the environment for the proliferation of pathogenic microorganisms. A sharp increase in pH in urine is a symptom of diabetes, tuberculosis, etc.

Protein (PRO). In urine it should be absent or not exceed 0.033 g/day. If all the rules of personal hygiene and general recommendations for collecting material are followed, and protein is still present in increased quantities, this condition is called proteinuria. Basically, protein in the urine during pregnancy indicates preeclampsia, cystitis, allergies, nephropathy or pyelonephritis.

Glucose (GLU). The presence of sugar in a urine sample is considered an abnormality. In case of nervous shock or a diet with a high amount of carbohydrates, its content can be determined at a rate of up to 0.083 mmol/l. Traces of sugar in the urine occur with gestational diabetes, obesity, abuse of sweets and fatty foods, and age over 35 years. Mild glucosuria is typical for the second trimester of pregnancy and does not require treatment.

Bilirubin (BIL). Occurs as a consequence of hepatitis, blockage of the bile ducts or obstructive jaundice. An associated symptom is dark brown urine.

Ketone bodies (KET). Their presence in urine is considered a pathology. Ketones appear as a result of the breakdown of body fat reserves during glucose deficiency. They appear in the urine during severe toxicosis, fasting, and diabetes. If ketone bodies are present in the analysis, the smell of urine during pregnancy will resemble acetone. In this case, a carbohydrate diet and alkaline drinking are indicated.

Leukocytes (LEU). Leukocytes in the urine during pregnancy are produced by the body's immune system in response to the “invasion” of the pathogen. In the absence of diseases, there are 0-5 “control” leukocytes in the field of view. If inflammation begins in the genitourinary system, the number of leukocytes instantly increases.

Epithelium. Epithelial cells cover the mucous surfaces of organs. The presence of squamous epithelium in the urine is allowed (0-3 in the field of view), but renal epithelium should always be absent. Transitional epithelial cells may appear in single quantities. If the epithelium is excreted in large quantities in the urine, it means that an inflammatory disease has begun. Where exactly this happens is determined by the type of epithelium.

Red blood cells (RBC). The presence of two or more red blood cells in the urine during pregnancy occurs during infectious diseases, and blood in the urine during pregnancy may become obvious - it takes on the color of “meat slop.” Also, erythrocyturia can occur with essential hematuria in pregnant women (microtrauma of the pelvic vessels), which is considered normal.

Nitrites (bacteria). Determined in urine in case of bacterial infection of the urinary tract. Often the diagnosis is incorrect, especially if the woman was not properly prepared for the tests. If repeated testing confirms bacteriuria, additional laboratory tests are performed and adequate antibacterial treatment is prescribed.

Other indicators. Fungi, mucus, casts, if detected in bad urine during pregnancy, always accompany various diseases and require additional diagnostics.

Additional urine tests

In addition to clinical analysis, a number of additional laboratory tests of urine are also carried out. In this way, sluggish or completely asymptomatic diseases are diagnosed in a timely manner, which is especially important during pregnancy. But a referral to a tank for urine culture or daily diuresis should not frighten pregnant women. As a rule, this is common prevention.

Bacteriological culture of urine

A urine sample is sent for bacteriological culture if a pregnant woman is found to have high leukocyturia, nitrites and red blood cells during a routine urine test.

Culture will confirm the presence of pathogenic microflora and determine which bacteria in the urine during pregnancy provoke the microbial inflammatory process. A test is also carried out to determine the resistance (sensitivity) of microorganisms to the antibiotic. If a woman does not have clinical symptoms of bacteriuria, a course of antibiotics is still mandatory.

Important! Urine culture during pregnancy is carried out twice for preventive purposes: during registration, and also at 36 weeks of pregnancy.

Daily diuresis

This analysis is quite painstaking, but clearly shows whether there are kidney problems or stagnation of urine output. Prescribed for suspected gestosis and obvious edema of 3-4 degrees.

How it's done:

1. The duration of the test is exactly 24 hours, for example, from 7 am to 7 am the next day.
2. The first portion is not collected, and all subsequent portions are poured into a container with a volume of at least 3 liters.
3. A diary (schedule) is started, which indicates the exact amount of liquid that the woman will drink during the day.
4. The amount of urine excreted each time you visit the toilet is also recorded there.
5. After the specified time, the liquid with urine and the compiled report are taken to the laboratory.

This test shows protein, glucose, oxalates and metanephrines.

On a note! In the absence of pathologies, daily diuresis is at least 60% of the amount of fluid drunk. In this case, the majority of urine should be excreted during the day, and not at night.

Urinalysis according to Nechiporenko

This type of diagnosis is not routine for pregnant women, but is often prescribed. The reason for this is the patient’s set of complaints from the bladder or the indicators of a routine urine test are on the border of normal.

What does this analysis show:

1. Leukocytes (normal 1-6).
2. Red blood cells (normal 1-3).
3. Cylinders (20 units/ml).

Often pyelonephritis or hematuria is asymptomatic, and such an analysis helps confirm their presence.

Urine analysis according to Zimnitsky

This analysis is similar to the analysis of daily diuresis, but urine is collected in different containers. You will need 8 of them in total.

How to collect material for analysis:

1. 8 sterile containers for urine are purchased.
2. Every three hours, a portion of urine is collected and the procedure time is recorded in the appropriate field on the container.
3. The procedure lasts 24 hours and after filling the last container, all the material is taken to the medical facility.

Advice! It is better to start collecting urine at 7-8 am, so that you can immediately take it to the laboratory the next morning.

Glucosuric profile

A rather specific urine test, which is carried out when there is a strong excess of sugar in the urine. In this case, a blood sugar test is required to rule out gestational diabetes. The presence of glucose in the urine appears when the kidneys of a pregnant woman are under heavy load, since they do not have time to completely absorb it and are excreted from the body through urine. This phenomenon occurs in 50% of women, but additional examinations using a glucosuric profile are still carried out.

This test requires collecting five urine samples in separate sterile containers at specific times:

• 1st collection from - from 9.00 to 14.00;
• 2nd gathering - from 14.00 to 19.00;
• 3rd gathering - from 19.00 to 23.00;
• 4th gathering - from 23.00 to 6.00;
• 5th gathering - from 6.00 to 9.00.

Constantly undergoing tests and frequent anxiety from waiting for their results causes a lot of discomfort for expectant mothers. But in an “interesting” situation, it is always better to overdo it than to miss hiding a disorder in the functioning of the kidneys, as well as other organs, and defeat the disease in time. Then you and your future baby will be healthy and happy when you first meet.