During the entire period of pregnancy, a woman must be registered with the antenatal clinic. Regular examinations and laboratory tests are not a whim of doctors, but the most accessible mechanism for identifying pathologies developing in a woman’s body at an early stage.
Changes of this nature can be dangerous not only for the expectant mother herself, but also for the fetus, therefore treatment must be fully provided. Even such a change as protein in the urine during pregnancy can be dangerous.
If there is increased protein in the urine during pregnancy, we can talk about the development of proteinuria. Such a change may indicate development various diseases posing a serious threat to women's health.
Their danger primarily lies in their partially asymptomatic course; in the absence of examinations, the process can progress and report its development only at an advanced stage. Laboratory tests help identify the development of pathology.
The doctor will be able to tell the patient the reasons that provoke the development of the disorder and tell her how to treat the disease. What is the norm for protein in the urine of pregnant women and what to do if the indicators do not meet these limits - answers to the most popular questions are presented to the reader.
Urine in the kidneys is formed by extraction from the blood, therefore, at the initial stage of filtration, the presence of a substance in the urine is normal. In subsequent stages, the protein returns back to the blood, but minor traces of it may be present in the patient’s urine.
Attention! Modern chemical reagents are not able to detect protein in a patient’s urine if its concentration is less than 0.03 g/l. If the protein in the urine of pregnant women is higher than these levels, it is worth paying attention to establishing the cause of its appearance.
The pregnancy period for any woman is quite expected, desired and nice time, which is often overshadowed by various difficulties. It is often at this moment that health problems appear, and even a previously healthy body suffers from severe failure.
This is due to the fact that the body at this time is “responsible for two lives,” therefore all organs face an active load. This involvement also applies to the kidneys.
Traces of protein in the urine of pregnant women may appear for physiological reasons, when an enlarged uterus or other organs displaced under pressure interfere with the flow of certain vital processes. Under these circumstances, change is not a reason to panic.
| Increased protein in urine in pregnant women | |
| Type of proteinuria | Description |
| Functional proteinuria | If traces of protein appear in the urine during pregnancy, the reasons may be different. Indicators ranging from 0.034 g/l to 0.14 g/l) may indicate mild metabolic disorders. the woman does not experience any discomfort and there is no threat to pregnancy. Indicators can increase and return to normal on their own. Such changes do not indicate the development of an acute problem. Change often occurs due to the following reasons:
Such a change is not dangerous for the mother and fetus and is simply corrected with the help of a diet and a special regimen. |
| Pathological proteinuria | The condition occurs when the indicator exceeds 0.25 g/l. In this case, the causes of protein in the urine during pregnancy may be as follows:
The most common cause is the active pressure of the uterus on the kidneys, which causes a disruption in their blood supply. |
| False-positive proteinuria | The reasons for a false positive reaction may be the following:
The development of proteinuria may be indicated by a simultaneous increase not only in protein, but also in leukocytes. |
The reasons for the increase in protein in the urine during pregnancy may be different, but it should be remembered that such a process in any case requires constant medical supervision.
What reasons provoke
During pregnancy, protein in the urine increases quite often. It is worth remembering that such a change is not an independent disease, but only indicates the development of certain pathologies in the body.
The norm of protein in daily urine during pregnancy is not determined as an indicator. As a rule, during normal kidney function, this substance is not detected in the patient’s urine. Many factors can provoke such a change, and proteinuria is not always evidence of a pathological process.
The list of main reasons that can provoke a change can be presented as follows:
- presence in daily diet a significant amount of proteins;
- increased physical activity resulting in overwork on the eve of taking the test;
- failure to comply with urine collection rules;
- a woman’s constant presence in stressful situations;
- increased body temperature;
- prolonged exposure to the sun.
If the above reasons are eliminated, the risk of grade increases can be eliminated.
Attention! The norm of protein in urine during pregnancy is no more than 0.03 g/l. The substance in such volumes is not detected during the test.
Considering the question of why protein in the urine of pregnant women cannot exclude possible pathological processes discussed in the table:
| What pathological changes may proteinuria indicate? | |
| Pathology | Description |
| This disease manifests itself as inflammatory process, covering the kidney tissue, manifested against the background of stagnation of urine and the addition of infection. This condition is accompanied by an increase in protein in the urine and severe pain in the lumbar region. In the chronic course of the pathological process, symptoms may also appear in acute form. This pathology during pregnancy is extremely dangerous - the disease can cause intrauterine death fetus | |
| The most common cause of proteinuria during pregnancy is cystitis. The symptoms of this disease often bother expectant mothers. The pathology is manifested by disturbances in the normal process of urination. | |
At the initial stage of development, damage to the renal glomeruli appears; over time, the renal tubules are involved in the process. The clinical picture is acute:
If the protein in the urine increases by later hypertensive crisis is likely. Proteinuria levels reach a maximum of 25 g/l with a joint increase in red blood cell counts. Urine may take on a red tint. |
|
| Nephropathy | Violation of normal kidney function, which manifests itself in the last stages of pregnancy. The pathological process often manifests itself adjacent to gestosis. Characteristic features:
The protein level in most cases does not increase above 5 g/l. |
When to sound the alarm: symptoms of pathology
The clinical picture of the pathological process largely depends on the causes of the disease. It is worth noting that the intensity of symptoms depends on the activity of the provoking bacteria.
Typical symptoms that women should pay attention to include:
- decreased activity;
- constant feeling of fatigue;
- gagging in the 2nd and 3rd trimester of pregnancy;
- change in the frequency of the urge to urinate;
- kidney pain;
- increased blood pressure.
Such manifestations indicate that a woman should undergo a urine test for protein during pregnancy.
With late gestosis, proteinuria often appears. Such a change is extremely dangerous.
List of characteristic symptoms:
- disruption of hormone production processes;
- disturbances in the functioning of the nervous system;
- rejection of the fetus by the woman’s body;
- swelling of the limbs;
- convulsions;
- deterioration of fetal vital signs due to contamination amniotic fluid.
White flakes in the urine during pregnancy in the morning are a sign of sobriety. A woman should undergo a urine test for daily protein as soon as possible.
Norms of indicators
A urine test during pregnancy should not show protein. During the normal course of the gestation process, in the absence of pathologies of internal organs, this element is not detected modern methods laboratory diagnostics.
Attention! Protein in urine is normal during pregnancy in the last stages - it can be about 0.033 g/l. This change does not indicate the development of a pathological process, but is a consequence of active pressure on the kidneys.
In some cases, an increase in levels to 0.14 g per liter also does not indicate the development of a pathological process. Such a change is acceptable during multiple pregnancies.
A cause for concern should be an increase in levels of more than 2-3 g/l. such a change may indicate the need for emergency hospitalization of the woman. in some cases, when amniotic fluid is contaminated for periods of more than 32 weeks, C-section. Protein in daily urine during pregnancy (normal) is 100-200 mg/day. When the level rises to more than 300 mg/day, severe proteinuria is diagnosed.
Important! To determine the diagnosis, a single detection of elevated protein levels in the urine is not enough. The diagnosis can only be confirmed through repeated examination.
How to donate urine: basic rules
The list of preparation rules that normalize the features of urine collection for protein determination can be presented as follows:
- do not take diuretics on the day of collection and the evening before;
- taking medications that affect kidney function on the day of urine collection is canceled;
- the patient should drink water in normal volumes that are familiar to him;
- You should not radically change your diet.
Instructions for collecting urine can be presented as follows:
- You should buy a special container for urine at the pharmacy (pictured).
- Immediately after waking up, the genitals are toileted, after which the water remaining on the genitals is carefully removed with a clean and ironed towel.
- The first portion of urine is flushed into the toilet.
- Only the middle portion should fall into the container. There is no need to worry about a small amount of material.
- It is prohibited to pour biomaterial from several containers.
- Urine must be delivered to the laboratory within 1.5-2 hours.
Before donating biomaterial, you should make sure that the container is marked with the patient’s name and date of birth.
Why is protein dangerous?
The most dangerous thing for mother and fetus is pathological proteinuria without timely treatment.
The list of the most common and dangerous changes can be presented as follows:
- purulent process;
- blood poisoning;
- infection of the placenta and anatomical fluid;
- kidney failure;
- fetal hypoxia;
- death of a woman;
- death of the fetus in the womb;
- premature birth.
The video in this article will tell readers about the main danger of proteinuria and introduce it to its early signs.
Treatment
The therapeutic technique that allows you to cope with proteinuria in each individual case is selected individually, taking into account the provocateur factor.
Treatment is based on following simple rules:
- Taking medications in doses prescribed by a doctor.
- Following a special diet.
- Easier daily routine.
- Healthy lifestyle, regular walks.
For proteinuria that occurs against the background of infectious processes, it is necessary to take antibacterial agents. Can be used as adjuvant therapy folk recipes. To normalize kidney function, you must follow the rules of a healthy diet.
Basic rules ensuring speedy recovery can be represented in the following form:
- reducing the volume of fluid consumed;
- taking sedatives;
- taking antioxidants;
- use of drugs to normalize the condition of the placenta;
- taking magnesium;
- use of diuretics.
Similar methods are used for mild to moderate proteinuria. In advanced cases, a cesarean section is performed, because prolonged stay in the womb is dangerous for the fetus.
Prevention
It is possible to reduce the risk of developing proteinuria by following the following recommendations:
- weight gain control;
- regular visits to antenatal clinic;
- adherence to healthy eating rules;
- refusal of salt and spices;
- control of blood pressure indicators;
- light physical activity;
- increased immune indicator;
- taking vitamin complexes;
- walks in the fresh air.
What does protein in a pregnant woman’s urine mean is now known. If a woman has any problems with her kidneys before pregnancy, she should contact a nephrologist at the planning stage. Excessive care will prevent the development of serious health problems during pregnancy.
Compliance with the simple rules given above allows you to make your pregnancy period the safest, most enjoyable and simplest. A woman must remember that at this time she has in her hands not only her own health, but also the life of her unborn baby, therefore she must approach any changes with extreme vigilance.
Urine is formed by filtering blood in the glomeruli and is practically devoid of protein - normally the pores of the glomerular membrane are too small for protein molecules to pass through them.
In the reference norm, urine does not contain protein.- Proteinuria– amount of protein in urine more than 0.033 g/l.
1. Damage/inflammation of blood vessels in the kidney. Changes in the wall of glomerular capillaries increase their permeability to protein molecules.
2. Decreased reabsorption (reabsorption) of protein and water in the renal tubules.
3. Reduced blood flow in the kidney, stagnation of blood in the renal glomeruli.
Consequences of pathological proteinuria.1. Proteinemia is a decrease in protein concentration in the blood plasma.
Normal indicators of protein metabolism:
- total blood protein: 65 – 85 g/l
- blood albumin: 35 – 50 g/l
2. Hypertension – blood pressure increases due to increased production of the antidiuretic hormone ADH and aldosterone.
3. Hypercholesterolemia – increased levels of lipids in the blood.
4. Retention of salts and water in tissues with the formation of edema.
Long-term massive proteinuria ≥3.0-3.5 g/day leads to a decrease in the concentration of albumin proteins in the blood plasma - it is albumins that keep the liquid part of the blood from flowing through the capillaries. Loss of protein in the urine potentiates tissue edema.
The appearance of protein in the urine during pregnancy in excess of the permissible norm can be a clinical symptom of late toxicosis of pregnancy, or more precisely one of the forms of gestosis - nephropathy of pregnant women with diffuse kidney damage.
Changes in the kidneys during gestosis are similar to membranous glomerulonephritis with severe degeneration of the epithelium of the renal tubules. During gestosis, not only the kidneys suffer; pathological changes in the liver, myocardium, and cerebral vessels are possible. As a rule, all these disorders disappear soon after childbirth.
Pregnancy itself cannot cause irreversible changes in the kidneys and other vital organs. If proteinuria and accompanying symptoms persist after childbirth, then it can be argued that certain chronic/undetected diseases existed in the patient before pregnancy.
Norms of protein in urine
Squirrel tracks in urine during pregnancy have no clinical significance. Mild proteinuria (traces/1+) is most often transient and benign.
General analysis of morning urine. Norm.
How to correctly collect morning urine for general analysis?
1. In the morning (6.00 – 8.00 hours, immediately after sleep), wash thoroughly.
2. Collect the ENTIRE morning portion of urine in a clean, dry container (pot) specially prepared for this purpose.
3. Pour 100–200 ml of collected urine into a clean, dry container.
4. Deliver the container with urine to the laboratory no later than 2 hours after its collection.
How to properly collect daily urine?
1. Prepare a clean, dry, large container with a capacity of up to 3 liters (2-3 liter jar with a lid) for collecting daily urine.
2.
Prepare a clean, small container with a capacity of about 200 ml to deliver the 24-hour urine sample to the laboratory. Label:
Full name_____
Exact time to start urine collection: (for example, 9.00)
Volume of fluid consumed per day: (—)
Total urine volume per day: (—)
3. Prepare a clean pot and a “Journal of liquids consumed per day.”
4. In the morning at 9.00, empty your bladder (the first portion of urine) into the toilet.
5. Collect all subsequent urine within 24 hours in a pot and pour into a large container. Record the volume of each portion of liquid you drink in the Logbook.
6. At 9.00 the next morning, collect the last portion of urine and pour it into a large container.
7. Measure the total volume of daily urine, calculate the volume of liquid drunk per day. Enter the information on the small container's label (—).
8. Shake the urine in a large container, pour 100-200 ml into a small container and immediately deliver the sample to the laboratory.
Attention!
1. The large container should be kept in the refrigerator during urine collection.
2. If at least one urine portions have not been collected into a large container within 24 hours - pour out all collected urine. The next morning, repeat the urine collection procedure correctly.
Rapid testing of urine for protein using diagnostic strips.
Decoding.
Protein designation on the express urine test form:
GLU…….glucose
PRO…….protein/protein
BIL…….bilirubin
URO…….urobilinogen
PH……….urine reaction/ pH
S.G. …..relative density
BLD…….blood/hematuria
KET…….ketones
NIT…….nitrites
LEU…….leukocyte esterase
Functional/benign proteinuria
Minor, less than 0.3 g/day, isolated (there are no other symptoms of ill health), transient (that is, no) appearance of protein in the urine during pregnancy is not always a sign of pregnancy pathology or kidney disease.
Causes of functional/physiological/benign proteinuria- Nephroptosis - prolapse of the kidney.
- Orthostatic proteinuria.
Curvature (lordosis) of the lumbar spine - lordotic proteinuria.
A phenomenon where, when collecting urine in a standing position, a fairly high protein content is revealed. If urine collection is done in a lying position, there is no protein in the urine. Orthostatic proteinuria is characterized by the absence of protein in the morning (collected immediately after sleep) portion of urine. This type Proteinuria is more often observed in young pregnant women (under 18 years of age), as well as in tall, thin women.
- Tension proteinuria.
Occurs after a large and prolonged physical activity, intense sports training. Protein in the urine completely disappears after a few hours or 1-2 days after the end of the load.
Dehydration due to poor drinking habits and increased sweating.
Blood thickening, especially in hot weather, leads to a concentration of albumin proteins in the blood plasma and may be accompanied by their appearance in the urine.
- Nutritional proteinuria.
Transient proteinuria, as a result of febrile (hyperthermic) conditions, hypothermia, stress.
The result of a high-protein diet is also the abuse of spicy, salty foods and alcohol.
- Congestive proteinuria in pregnant women.
Due to the growth of the pregnant uterus, hemodynamics in the pelvic area are disrupted, blood flow in the kidneys slows down, and urine outflow worsens. Under such conditions, low-molecular-weight blood albumin proteins can be filtered through the pores of the basal glomerular membrane into primary urine.
Benign proteinuria:- Not dangerous.
- Not progressing.
- Does not require special treatment.
It is temporary - it appears and then disappears without treatment.
Not accompanied by any other symptoms - a thorough laboratory and instrumental examination of a pregnant patient does not reveal any pathology.
Pathological proteinuria
Exacerbation The following pre-existing diseases can cause the appearance of pathological proteinuria at any stage of pregnancy:
- Glomerulonephritis, nephritis of various etiologies.
- Pyelonephritis.
- Amyloidosis of the kidneys.
- Polycystic disease, kidney tumor.
- Autoimmune diseases - SLE, vasculitis, etc.
- Heart defects, s/s diseases.
With congestive proteinuria due to circulatory failure of various origins, there may be a lot of protein in the urine during pregnancy (from 2.0-3.0 g/l to 10 g/l).
- Urolithiasis.
False/postrenal/nonrenal proteinuria
If there is a transient minimal (≤0.3-0.5 g/l) or trace appearance of protein in the urine during pregnancy, it is necessary first of all to exclude false proteinuria not associated with kidney pathology. Her reasons:
- Failure to maintain personal hygiene during urine collection.
Infections of the genital organs and urinary tract - cystitis, urethritis, etc.
During infectious-inflammatory processes of the genitals/lower urinary tract, the urine may contain a large number of leukocytes, red blood cells, bacteria, as well as the epithelium of inflamed mucous membranes and purulent-protein secretion of the genital organs, which gives false positive result for protein in urine.
To confirm/exclude false proteinuria, additional urine tests are performed: Nechiporenko, Kakovsky-Addis, etc. tests.
Protein in urine due to early toxicosis of pregnancy
/prerenal proteinuria overflow/
Early toxicosis, a complication of the first half of pregnancy, usually occurs in the first 12 weeks of gestation.
Prerenal (non-renal) proteinuria of this period rarely exceeds 1 g/day and is a consequence of dehydration against the background of frequent vomiting, drooling (up to 1.5 liters of saliva can be released per day) and metabolic disorders in the body of a pregnant woman. By the 13-14th week of pregnancy, the condition of the expectant mother improves, the protein content in the urine normalizes.
Treatment of severe early toxicosis is carried out in a hospital, in some cases the question of artificial termination of pregnancy becomes a question.
Protein in the urine due to late toxicosis of pregnancy - gestosis
Triggers of gestosis:Disruption of hormonal homeostasis and dysfunction of the central nervous system in the mother’s body.
An immunological conflict between the body of the mother and the fetus leads to the development of immune inflammation in the kidneys and other tissues, and to the formation of edema.
The accumulation of harmful metabolic products - hysterotonic substances - in the edematous ischemic placenta and uterus causes an increase in the permeability of cell membranes and vascular walls, and aggravates edema and inflammation.
Functional overload of the kidneys in the second half of pregnancy aggravates all of the above processes.
- Hypertension.
- Congenital/acquired before pregnancy kidney diseases.
- Diabetes mellitus.
- Anemia.
- The patient has a history of taking nephrotoxic drugs.
- Tendency to allergic reactions, polyvalent allergy.
- Autoimmune pathology.
- Foci of chronic microbial infection (tonsillitis, caries, etc.)
- Smoking.
The appearance of proteinuria >0.3 g/day after the 20th week of pregnancy can be considered a clinical symptom of nephropathy in pregnancy.
Mild/benign forms of nephropathy occur without hypertension, are accompanied by moderate edema and an acceptable protein content in the urine (0.3 - 0.5 g/l). After childbirth, proteinuria disappears without a trace.
The frequency of late toxicosis of pregnancy ranges from 2.2 to 15%. Severe (combined with other pathologies) nephropathy in pregnant women can cause maternal and perinatal (soon after birth) child mortality.
Symptoms of gestosis
An indicator of the severity of a patient’s condition with gestosis is not so much swelling and the amount of protein in the urine, but arterial hypertension, especially high diastolic pressure.
Preeclampsia severity calculator
/as of the time of inspection/
Treatment
Specific treatment of gestosis with the appearance of protein in the urine in pregnant women is carried out obstetrician-gynecologist together with other specialists.
1. Gentle, in some cases, bed rest.
2. Diet No. 7c.
3. Drug treatment:
— sedative therapy;
— aminophylline, magnesium sulfate intravenously, intramuscularly.
- diuretics;
- antihypertensive drugs;
- anti-edematous (combating cerebral edema) measures: intravenous - reopolyglucin, Lasix, mannitol, glucose solution 40%, plasma, albumin solution 20%, etc.
Consultation with a resuscitator.
Treatment is carried out in a hospital, under constant monitoring of acid-base balance, blood clotting and kidney function.
Protein in the urine is one of the most common symptoms detected in late pregnancy. In the medical community, this phenomenon is called proteinuria. The appearance of protein in the urine may indicate the development of gestosis, a serious complication of pregnancy. Proteinuria in expectant mothers can also be associated with diseases of the kidneys, bladder and urethra.
Norm and pathology
All pregnant women are required to undergo a general urine test (UCA). This routine procedure allows you to timely detect protein in the urine, as well as track other changes in the kidneys and the whole body. OAM is taken before each visit to the doctor: every two weeks until 30 weeks and weekly from 30 weeks until delivery. A follow-up examination must also be carried out on the first day after the birth of the child.
For OAM, only the first morning urine sample, collected in a sterile container, is suitable. The material must be delivered to the laboratory no later than 2 hours later. Expectant mothers need to ensure that vaginal discharge does not get into the container. Failure to follow the rules for collecting analysis can lead to incorrect interpretation of the result and an incorrect diagnosis.
Normally there should be no protein in the urine. A single detection of protein in amounts up to 0.3 g per day is allowed. In this situation, the analysis should be retaken. If the protein concentration does not increase and the woman is not bothered by anything, treatment is not carried out. The expectant mother needs to carefully monitor her condition and report the slightest deviation to the doctor.
Physiological proteinuria is observed in the following situations:
Physiological proteinuria persists for a short time, after which protein disappears from the urine. The protein concentration does not exceed 1 g per day. The general condition of the woman is not impaired. If there is an increase in protein in the urine, you should definitely undergo examination by a specialist.
Pathological proteinuria
Warning symptoms to look out for:
- the appearance of protein in the urine early stages pregnancy;
- repeated detection of protein in the urine;
- protein level is above 0.3 g per day.
Laboratory signs are combined with a deterioration in the woman’s general condition. The development of pathology is indicated by:
- severe weakness;
- headaches;
- increased blood pressure;
- tachycardia;
- visual disturbances (blurred vision, flickering spots before the eyes);
- swelling of the face in the first half of the day;
- swelling of the hands, feet, and legs;
- involuntary muscle twitching;
- pain in the lumbar region;
- dysuric phenomena: pain, itching, burning during urination, increased frequency of urination, urinary incontinence or retention.
The combination of these symptoms with proteinuria is an unfavorable sign and requires mandatory medical supervision.
Among the causes of pathological proteinuria in late pregnancy special attention deserve:
Preeclampsia
The appearance of protein in the urine after 20 weeks most likely indicates the development of gestosis. This specific condition occurs only during pregnancy, childbirth, or the early postpartum period. The development of gestosis is accompanied by a triad of symptoms:
- arterial hypertension (increase in systolic blood pressure above 15 mm Hg and diastolic blood pressure above 10 mm Hg from baseline);
- swelling;
- proteinuria.
The appearance of protein in the urine is a late symptom of gestosis and indicates a violation of the kidneys. In this situation, the expectant mother is monitored with constant monitoring of blood pressure and the condition of the fetus. If indicators worsen, hospitalization in a hospital is necessary. The shorter the pregnancy due to gestosis, the worse the prognosis and the higher the likelihood of complications.
In the absence of adequate therapy, severe gestosis develops into preeclampsia. In this state, diuresis decreases, blood pressure increases significantly, and protein in the urine increases. Without treatment, preeclampsia progresses to eclampsia - the most dangerous complication of pregnancy. Convulsions develop, and there is a real threat to the life of the woman and the fetus. Save expectant mother and her baby is possible only with emergency medical care. In this situation, a caesarean section is performed regardless of the stage of pregnancy, infusion therapy and other measures to save the woman’s life are prescribed. Neonatologists provide care to the newborn.
Prevention of eclampsia includes:
- Regular monitoring by a gynecologist throughout pregnancy.
- Timely delivery of OAM and other tests.
- Control of blood pressure, weight and diuresis.
- Timely treatment of gestosis.
At risk for developing gestosis are women with overweight and previous arterial hypertension. This category of expectant mothers should especially carefully monitor their health and, if they have the slightest doubt, consult a doctor.
Kidney and urinary tract diseases
In the second half of pregnancy, the load on the kidneys increases significantly and the likelihood of exacerbation of certain diseases increases:
- glomerulonephritis;
- pyelonephritis;
- interstitial nephritis;
- cystitis;
- urethritis, etc.
Proteinuria in renal pathology is accompanied by other changes in the TAM. During inflammation, the level of leukocytes increases and bacteria are detected in the urine. Some diseases are accompanied by an increase in the concentration of red blood cells, the appearance of casts, glucose, and the precipitation of salts. The final diagnosis is made after ultrasound and other examination methods available during pregnancy.
Pregnancy is a wonderful and, at the same time, anxious period for every woman. All kinds of examinations must be carried out in order to identify any problems in the early stages and, if possible, try to eliminate them.
This can be caused by a natural process that occurs in the body, for example, an enlargement of the uterus (the uterus increases in size, thereby disrupting the normal blood supply to the urinary ducts and kidneys).
Diseases that provoke excess protein in the urine in pregnant women (see acceptable standards in the table below):
- infection of the urinary ducts;
- renal polycystic disease;
- hypertension;
- infectious kidney diseases (meaning: glomerulonephritis and pyelonephritis);
- high sugar due to diabetes;
- heart failure;
- gestosis.
The most dangerous factor in the appearance of traces of protein in the urine of a woman in an “interesting” position is a disease called gestosis.
This diagnosis may be accompanied by severe swelling of the limbs and face, which is most likely caused by increased vascular permeability and chronic hypertension, in addition, there is tinnitus, severe dizziness, weakness or fatigue.
Typically, gestosis manifests itself in the second trimester of pregnancy. Such a disease disrupts the normal development of the placenta, thus, the baby who has not yet been born is in danger. The fetus does not receive the required amount of oxygen and nutrients.
Such phenomena usually provoke premature birth, worse than that - slow development of the fetus.
If the pathology is not identified in time and no action is taken for treatment, the baby may be born dead.
Less dangerous causes of the appearance of protein in the urine, such as pyelonephritis and glomerulonephritis.
The first is characterized by pain and discomfort in the lower back and bladder. An indicator of the second is the unusual color of urine - the presence of a fleshy color. With pyelonephritis and glomerulonephritis, in addition to the presence of protein, it manifests itself in the urine large availability leukocytes and erythrocytes.
The condition of a pregnant woman in itself is characterized by unpredictability. A woman in an “interesting” position may not even be aware of any abnormalities in her body, because before pregnancy everything was normal. In addition, after childbirth, all the problems that were present during pregnancy disappear.
The appearance of protein after childbirth and cesarean section
Analysis for the presence of protein in urine is important not only during pregnancy, but also after it. If after childbirth increased protein is found in the urine, then this indicates problems in the woman’s body, perhaps this is - inflammation of the kidneys or inflammation of the genitourinary system.
Every woman in labor needs to be examined without fail, this is the only way to prevent all health ailments, otherwise everything can end in disaster. Due to untimely examinations, serious pathologies associated with renal failure are observed.
There are no obvious signs of the appearance of protein. All symptoms (lower back pain, fatigue, tiredness, swelling) can be attributed to the troubles with the baby. The reasons for the appearance of protein in the urine after childbirth are the same as during pregnancy.
To eliminate kidney problems, you should not neglect your doctor’s advice and examinations.
Acceptable standards
Normal protein levels are considered to be: total blood protein: 65 – 85 g/l and blood albumin: 35 – 50 g/l.
Let's look at the different protein readings:
- 0,066 - 0,099. These readings indicate impaired kidney function; they are working under strain. This may be due to eating large amounts of protein foods or exercising. Most likely, your attending physician will require you to retake the test.
- 0,1 - 0,2. Such indications may indicate previous colds.
- 0,25 - 0,3. Another similar examination is necessary, and you may need to take a Nechiporenko test. A mandatory kidney ultrasound is performed. After everything, we can already talk about an accurate diagnosis.
- 0,3 - 1,0. This protein level indicates severe proteinuria. Prescriptions are written by an experienced nephrologist, since various types of kidney pathology may be present.
Daily loss
In a normal healthy person, the glomerular membrane filters proteins exclusively with low molecular weight. After this, a certain part of them is absorbed into the kidney tubules.
Consequently, the daily loss of protein along with urine during pregnancy is so small that, in principle, protein in the urine is not visible when analyzing the results. Development of proteinuria occurs due to damage to the glomerular membrane and tubular reabsorption.
The usual norm for the coefficient of protein excretion in urine during immobility is considered to be 50-100 mg/day. The presence of protein in a given dose of urine collected throughout the day may vary. For example, more protein is observed during the day than during the night.
A discrepancy with the norm implies the presence of protein in the urine, and then a 24-hour urine test is prescribed. This may help identify kidney pathology.
Weak proteinuria - less than 0.5 g/day.
Average proteinuria - from 0.5 to 1 g/day.
Overt proteinuria - from 1 to 3 g/day.
How to reduce protein in urine or get rid of it completely?
Prescribes therapy and diet to reduce protein during pregnancy specialized doctor, based on the outcome of the patient's analysis. First, you need to identify the reason why the protein has increased, then, based on the results of the examination, talk about getting rid of kidney problems.
Considering the fact that the woman is in an “interesting” and, at the same time, “unpredictable” position, it will not be so easy to prescribe, because not all drugs can be taken during pregnancy.
It may even require hospitalization so that the expectant mother is under the supervision of doctors at all times.
Mainly, specialists usually prescribe diuretics, because they are excellent helpers for removing protein from urine. For infectious kidney disease, it is recommended to drink herbs: chamomile, birch buds, thyme and other anti-inflammatory herbs.
If the examination showed pyelonephritis, then you will have to use antibiotics. Usually, pregnant women are afraid of the word “antibiotics,” but this is in vain. There are antibiotics that do not harm the baby in any way, but effectively fight the mother’s progressive illness.
If you have nephropathy, then you should stick to strict diet , which should only be prescribed by a specialist; perhaps he will also recommend so-called fasting days.
Do not self-medicate under any circumstances; consult your doctor.
If violations are detected in time and the cause is identified in time, then you can easily overcome this invisible but dangerous disease. Then your child will no longer be in any danger. Take care of yourself and your health!
Dr. Komarovsky will tell you in the video what medications you can take during pregnancy:
Protein is the main criterion that doctors pay attention to when studying the results of a pregnant woman’s urine test. The presence of a substance in a biomaterial may be the first sign of a condition that is most dangerous for a woman and fetus - gestosis. Normally, in expectant mothers this figure is 0.033 g/l.
But the result of the study may show deviations not only due to the renal factor, late toxicosis. Therefore, it is important to correctly differentiate the causes and determine when there is a serious danger and when minimal treatment will help.
Kidneys are to blame
The kidneys act as a filter. They drive blood through themselves, remove water with salts and metabolites from it, but retain vital substances - glucose and protein. Sugar should normally never pass into the urine. There are exceptions for protein. So, this may be due to the characteristics of kidney function, have physiological reasons. It often appears in the later stages, before childbirth. Then the analysis determines up to 1 g/l of protein. Renal (renal) proteinuria occurs when the organ's capacity is impaired. In this case increased rate recorded after eating a large number of eggs, physical activity, severe hypothermia.
But deviations may indicate pathologies. They occur when a structural unit of the kidney (nephron) is damaged and appear in the following diseases:
- acute and chronic glomerulonephritis;
- renal failure;
- pyelonephritis;
- kidney amyloidosis;
- nephrotic syndrome.
These changes are persistent and long-lasting. The amount of protein that is lost at a time exceeds 1 g/l. If the cause is damage to the glomeruli, then losses can reach 10-20 g/l.
Late toxicosis
Any kidney disease that a woman had before pregnancy increases the risk of developing preeclampsia. This is a severe pathology that makes itself felt after 20 weeks of gestation. It is characterized by severe swelling, loss of protein and increased blood pressure. The severity of the condition is determined using a special table. It takes into account seven indicators, one of which is the amount of protein in the urine.
If proteinuria does not increase during pregnancy, this is a favorable prognostic sign. If, on the contrary, there is a gradual increase in protein in the tests, gestosis is considered progressive. In this case, urgent hospitalization is necessary.
Usually, along with the loss of protein, there is a persistent increase in blood pressure and swelling. This is due to the fact that protein is able to bind large amounts of water in the body. When it is lost, the substrate that holds water in the bloodstream is also lost, so it goes beyond the vessels and permeates the tissues.
Severe gestosis goes through the stage of preeclampsia or nephropathy of pregnancy. In this case, in addition to the main symptoms, additional symptoms appear:
- headache;
- heaviness in the back of the head;
- flashing “flies” before the eyes;
- nausea, vomiting;
- pain on the right under the ribs;
- memory impairment;
- insomnia;
- lethargy and irritability.
Often preeclampsia leads to eclampsia and the addition of seizures. Moreover, the process is developing very quickly.
Other reasons
The reasons do not always lie in kidney damage. Conditions that are associated with pathology of the underlying urinary tract are affected:
- cystitis;
- urethritis;
- colpitis
Unlike late toxicosis, these pathologies can appear already at an early stage of gestation. But it is not typical for them to detect large amounts of protein: usually the concentration does not exceed 1 g/l. But there will definitely be other impurities - leukocytes, erythrocytes. Inflammatory diseases are rarely asymptomatic. Common signs for them are:
- urinary disturbance;
- frequent urge to go to the toilet;
- pain and burning;
- feeling of incomplete emptying.
With colpitis, copious discharge from the genital tract, itching, and pain during sexual intercourse are also noted.
If, during inflammation in the vagina, urine is collected incorrectly, then the inclusion of secretions in the tests will lead to incorrect interpretation. Therefore, the collection of biomaterial is done after a thorough toilet, covering the genital slit with a piece of cotton wool.
Risks for woman and fetus
A pregnant woman regularly undergoes urine tests in order to identify pathological processes in time and avoid the development of complications. The latter can be extremely dangerous for the health of mother and child.
Infection
Colpitis, cystitis or urethritis are always infectious in nature. Any microbial focus in the body is associated with the risk of infection of the fetus. In the early stages, this often leads to miscarriage, in a later period it causes intrauterine infection, polyhydramnios, and affects the placenta. Inflammation in the genital tract increases the risk of transmitting the pathogen to the child during childbirth.
Preeclampsia
Often this condition is accompanied by the development of placental insufficiency and chronic fetal hypoxia. Children are born low birth weight, with reduced adaptive abilities.
There is a risk of premature detachment of a normally located placenta and antenatal death. This most often occurs with a long-term persistent increase in blood pressure.
For a woman, gestosis is dangerous due to the development of the following complications:
- acute renal failure;
- pulmonary edema;
- hemorrhages in the adrenal glands and other organs;
- cerebral coma;
- HELLP syndrome.
It is impossible to cure gestosis at home. Delay in this situation or hope for folk remedies may lead to the development of irreversible consequences.
Survey
Diagnosis is aimed at identifying the causes of proteinuria. Already a clinical urine test will help to approximately suggest a diagnosis.
- Infection. If the kidneys are affected (pyelonephritis), a large number of leukocytes and a cloudy sediment appear. During an infectious process in the bladder or urethra, bacteria and mucus are also detected. Nechiporenko and Addis-Kakovsky tests help differentiate estia from renal proteinuria.
- Preeclampsia. There is no sediment in the biomaterial; the amount of protein may vary.
For accurate diagnosis, special studies are required:
- daily diuresis;
- loss of protein in urine per day;
- character of sediment;
- Zimnitsky test;
- blood test for uric acid, urea, creatinine.
The woman’s overall weight gain over the entire period of gestation is also assessed.
During pregnancy, daily protein in the urine is considered normal if it falls within the range of 0.025-0.150 g/day. A decreased value is not considered a disease. On the contrary, this is a good sign of the absence of complications associated with kidney function.
Treatment
Traces of protein in the urine are not considered a pathology unless there are additional signs. But the combination with arterial hypertension, edema, and damage to other organs indicates a serious illness. Treatment depends on the identified causes and the severity of the condition.
You can get rid of an infection in the bladder and urethra using antibiotics. Most often these are protected penicillins, which can be prescribed at any time. From the second trimester, cephalosporins are added to them. A diet that acidifies urine, drinking cranberry juice and decoctions of “kidney” herbs is recommended.
Preeclampsia and any kidney pathologies require a special approach. Only first degree edema can be treated at home. The second and third require hospitalization. Women with proteinuria and high blood pressure should not eat salty foods. Taking into account protein losses, foods should be rich in proteins, but with a reduced amount of fat.
The goal of treatment is to restore and preserve the functions of vital organs, prevent seizures and help the woman give birth to a child. To reduce blood pressure, a solution of magnesium sulfate is prescribed. To normalize the volume of circulating blood and its rheological properties, solutions of crystalloids and colloids are used. Drugs that improve the condition of the placenta and help sedate the woman are also needed.
Early delivery
But there are indications in which the only treatment method is early delivery:
- average degree of gestosis- no expected effect from treatment for seven days;
- severe gestosis - no effect for two to six hours;
- regardless of severity- third degree fetal growth retardation during treatment.
In case of eclampsia and its complications, a decision is made within two to three hours.
