The main parameters of a general urine analysis are very important criteria by which doctors can determine various pathologies of pregnancy at the earliest stages. The appearance of protein in the urinary sediment during the gestation of an unborn child is a rather unfavorable symptom that requires careful monitoring. This article tells about what normal values of this indicator exist, as well as what is considered a pathology.
Standards
Urine is produced in the kidneys. Filtration of fluid occurs in special anatomical structures - the renal tubules. These microscopic formations help the body get rid of all toxic metabolic products that it no longer needs.
Kidney function is of particular importance during pregnancy. In this case toxic formations through the kidneys are excreted not only from the mother's body, but also from the fetus. Waste products are also filtered through the renal tubules, since the baby's urinary system is formed somewhat later.
Normal in any urine there must be no protein... The appearance of this substance in the urinary sediment should be the reason for a mandatory visit to a doctor.
Quite often, this condition is passing, in this case it is required obligatory repeated laboratory test. Gynecologists note that during pregnancy, women often have situations when traces of protein appear in the urine. This value of the analysis does not mean at all that this is a pathology. Doctors have even come up with a special term for this condition - transient or benign protein loss.
In the early stages of pregnancy, the result of a urinalysis performed in a woman should not differ significantly from normal normal values. In this case, there should be no protein in the urinary sediment. In some cases, especially if the urine was collected in the very early morning hours immediately after getting out of bed, traces of protein may appear in the analysis.
Doctors believe that the first trimester is very important for fetal development.
It is during this period that all the main organs and systems will be laid in the unborn child. The burden on the kidneys of a pregnant woman at this time is minimal. A significant increase in protein in the urine is already a consequence of, as a rule, diseases of the mother's kidneys or urinary tract.
The appearance of a protein in the value of 0.066-0.33 usually occurs in the third trimester. The development of such a situation indicates a decent load on the kidneys. At 37-39 weeks of gestation, the renal tubules filter urine already in an enhanced mode. Reviews of young mothers also indicate that many of them experienced such a phenomenon in the late stages of bearing babies.
High levels of protein, rising above 3 g / liter, doctors call proteinuria. This is already a pathological condition. Proteinuria can be persistent, but is most often transient. In this case, after childbirth, the woman may develop any kidney or urinary tract diseases. They are the result of persistent proteinuria, which occurred during the period of gestation.
For the convenience of assessing the results of urine analysis, doctors use special tables, which contain the main values of the normal indicators of this laboratory test. In order to carry out the correct interpretation of the results, quite a few different clinical indicators are evaluated. So, if the expectant mother bears twins or twins, then in this case she often has protein up to 0.15 g / liter in her urine.
In order to clarify the diagnosis, doctors may prescribe an additional analysis - determination of daily protein... This laboratory test more accurately shows whether there are any problems with urine filtration in the female body. Normal daily analysis values do not exceed 0.2 g / day. In many women with initial manifestations of renal filtration disorders, the obtained values are 0.1 g / liter, but if the indicator shows 0.3 g / liter or more, then it signals the need to correct this condition.
General analysis is a fairly comprehensive study. Despite its simplicity and routine, it allows for a very comprehensive assessment of kidney function. To exclude concomitant diseases of the urinary tract, doctors also quantify some indicators:
- Leukocytes - This is an important marker of existing infections or pathologies of the organs of the excretory system. In the normal course of pregnancy, this indicator shows less than 10 units in the field of view. In most cases, leukocytes are 1-5 in the field of vision. Exceeding this indicator should be a reason for seeking advice from a urologist or therapist.
- In normal general analysis also there are no bacteria. This is usually marked "+" or "-" on the medical exam form. The presence of bacteria is an extremely unfavorable condition, especially during pregnancy. Bacteriuria can lead to the development of dangerous infectious diseases of the kidneys and urinary tract.
- Erythrocytes Is another important indicator of normal kidney function. A combination of high protein and erythrocyturia is generally thought to be due to glomerulonephritis. This dangerous kidney pathology occurs quite often among the female population. Exacerbation of pyelonephritis during pregnancy is extremely dangerous. In this case, various disorders of the placental blood flow of the fetus may occur.
High protein symptoms
As a rule, a pregnant woman does not feel insignificant proteinuria. Appetite, sleep, body temperature remain in this case within normal limits. The appearance of protein in the urine up to 0.1 g / liter also does not contribute to the appearance of soreness in the lower back or the development of puffiness. The first "bells" of trouble appear later, when the values of protein in the urine increase significantly. Severe proteinuria and is accompanied by the development of many adverse symptoms.
The appearance of edema on the body is a characteristic bright symptom that accompanies this condition. The severity of the manifestation of this sign can be different. It usually increases by 38 weeks of gestation. Mothers carrying babies often complain that in the 3rd trimester they have severe puffiness on their face.
Edema can appear in various parts of the body, but there is also a "favorite" localization of the appearance of such puffiness.
As a rule, with renal proteinuria, edema appears on the face.
Quite often, they occur under the eyes. This feature is due to the fact that in this area the skin is quite thin and delicate.
Severe proteinuria is also accompanied by the appearance of edema on the legs. In this case, the legs swell more. Edema spreads in such a situation in an ascending direction - from the bottom up. The legs become looser and look swollen. When you press on the skin from above with your finger, a small dent is left, which disappears in a few seconds.
Some kidney pathologies are accompanied by the appearance of pain in the lumbar region. It usually increases with a change in body position or when walking fast. A distinctive manifestation of diseases of the urinary tract is the persistence of pain in the lower back, even at rest.
The occurrence of such a symptom should be a mandatory reason for contacting a urologist.
Expectant mothers usually detect the appearance of protein in urine on their own. In this case, they notice that the urine becomes more cloudy. In such a situation, a whitish suspension appears in it. Usually, this symptom manifests itself well in late pregnancy.
High body temperature is an extremely unfavorable symptom, especially during the period of bearing a future baby.
If this clinical sign is combined with soreness in the lower back and cloudy urine, then, most likely, it indicates the presence of exacerbated kidney or urinary tract diseases in the body of a pregnant woman.
With a rather severe course of exacerbation of chronic pyelonephritis, body temperature during pregnancy rises to 38 degrees. This condition is extremely unfavorable and requires urgent treatment. In some cases, especially in the late stages of pregnancy, the expectant mother can be hospitalized in a hospital to prevent the development of many dangerous conditions for the fetus.
Causes of protein in urine
A variety of causal factors can lead to the development of this condition.
Functional proteinuria can develop as a result of existing curvatures in the lumbar spine.
This clinical variant is also called lordotic. It arises due to the presence of a pronounced curvature in the lower back. In some cases, even collecting urine in an upright position can promote protein loss. In order to exclude this, doctors recommend collecting material for research while sitting. You can also collect urine while lying down.
This type of orthostatic (vertical) proteinuria is usually recorded in the morning portions. If the analysis is collected in the evening, then the protein may not appear. Usually, this clinical type of proteinuria develops in tall, thin women, as well as in expectant mothers who are not yet 20 years old.
Doctors note that after intense physical exertion, the amount of protein in the urine increases significantly. In the later stages, climbing stairs up several stairways can even lead to the appearance of this substance in the urinary sediment. In this case, to obtain a reliable result, it is imperative to exclude any physical activity a couple of days before going to the laboratory before collecting urine.
Quite often leads to the development of proteinuria severe dehydration. This condition can develop due to severe vomiting. Quite often, this pathology manifests itself in pregnant women with toxicosis. This condition can occur in several trimesters of pregnancy at once. The appearance of protein in the urine may also be the result of viral or bacterial infections. Usually, before the onset of this symptom, a sick pregnant woman has a high body temperature. Also, this condition can manifest itself after severe hypothermia.
Doctors also note a rather specific type of proteinuria, which is called stagnant proteinuria. It develops due to the fact that during pregnancy in the hemodynamics of the small pelvis, pronounced phenomena of blood stagnation begin to occur. This is due to the strong pressure of the uterus on nearby organs.
Errors in diet quite often contribute to the fact that strong metabolic disorders begin to develop in the female body. Usually leads to the development of this condition excessive consumption of various protein products, especially of animal origin. If, while taking an excessive amount of protein, a pregnant woman also eats a lot of salty and canned foods, then this leads to a significant progression of this condition.
In some cases, proteinuria can develop and with a number of diseases of the urinary system. These pathologies include renal amyloidosis, chronic glomerulonephritis and pyelonephritis, as well as various neoplasms and cysts that form in the renal tissue. Also, many autoimmune diseases lead to damage to the organs of the excretory system. Systemic lupus erythematosus and vascular vasculitis result in impaired renal blood flow, ultimately resulting in large amounts of protein in the urinary sediment.
Doctors note that the development of this pathological condition may be preceded by a strong immunological imbalance that occurs between the mother and her unborn baby. Strong immune inflammation contributes to the fact that edema appears on the body of the expectant mother.
Types of violations that arise
Doctors identify several clinical types of proteinuria that can occur during pregnancy. This classification helps doctors determine in which particular case a treatment will be required.
About functional proteinuria
Slight loss of protein in the urine is called functional proteinuria. This condition is recorded in pregnant women if the protein values in their urine do not exceed 0.14 g / liter. This state is just evidence of initial disturbances in metabolic processes in the body. This phenomenon is in most cases transient. It can develop several times during pregnancy. An increase in protein in the urine is already an extremely unfavorable symptom., indicating the progression of metabolic disorders.
A variety of reasons can lead to the development of this condition in a pregnant woman. These include hernias and pinching of intervertebral nerves, increasing pressure in the ureters (especially in the 2nd and 3rd trimesters), renal hypermobility and nephroptosis, severe psycho-emotional stress or inadequate physical activity. In these cases, you can get rid of the adverse manifestation without the help of any medications.
To correct the developed disorders, only strict adherence to a certain diet and the normalization of the daily regimen are required.
The gynecologist, together with the therapist, draws up a set of general recommendations that a pregnant woman must strictly observe while carrying a baby.
About pathological proteinuria
Doctors talk about the development of this condition if the protein in the urine has reached values of 0.25-0.3 g / liter. The development of such a pathological condition is usually caused by exacerbation of chronic diseases of the kidneys and urinary tract.
Quite often it happens that the expectant mother before pregnancy did not even know that she was suffering from these pathologies. Many of the diseases of the urinary system are "dumb" for quite a long time and appear only at times of increased stress on the body. This period is precisely pregnancy.
It should be noted that not only kidney or urinary tract diseases can lead to the development of this pathological condition in a pregnant woman. Existing diseases of the cardiovascular system and diabetes mellitus also provoke the loss of large amounts of protein in the urine during pregnancy.
In the later stages, strong pressure from the uterus on the blood vessels leads to the development of this condition. In this case, blood flow in the renal arteries is also disturbed. This contributes to the fact that urine filtration is slightly impaired.
About false positive proteinuria
Doctors exclude this condition when protein appears in the general urine analysis of a pregnant woman, but there are no various diseases of the kidneys and urinary tract. In this case, its values usually do not exceed 0.055 g / liter.This condition is not caused by diseases of the kidneys and urinary tract, but by violations in the implementation of the rules of personal hygiene. Irregular morning and evening rinsing can cause small amounts of protein to appear in the urine of pregnant women.
To exclude pathological proteinuria a mandatory assessment of other indicators of general urine analysis is required. An increase in the number of leukocytes or erythrocytes against the background of an altered density indicates that there are any chronic diseases of the kidneys or urinary tract in the body of a pregnant woman. In this case, it is also required to perform a urine culture tank to exclude the presence of infectious diseases. Women with these disorders must be registered with a nephrologist or urologist.
Why can this condition be dangerous?
Proteinuria is far from the safest condition during pregnancy. Its long and protracted course is especially unfavorable. In this case, this condition can lead to the development of adverse consequences.
Doctors consider one of these conditions development of chronic diseases of the kidneys and urinary tract... As a rule, the first adverse symptoms of these pathologies begin in expectant mothers during pregnancy, then over time these diseases progress and can bother a woman throughout her life.
Gestosis is another dangerous pathology, the development of which doctors try to prevent in patients who have signs of persistent proteinuria. The development of this pathology can lead to hypertension or diabetes mellitus in a woman before pregnancy. In some cases, gestosis develops without previous diseases. This pathology is usually accompanied by massive proteinuria. In this case, a pregnant woman can lose 5 or more grams of protein daily. Such a process will inevitably lead to pronounced metabolic disorders. Ultimately, this will contribute to the development in the unborn baby of signs of insufficient placental blood flow or the possible appearance of intrauterine developmental defects.
Doctors note that the incidence of this disease among pregnant women is increasing every year. In every 5 reported cases, the pathology is accompanied by severe kidney damage, which is called nephropathy. The severe course of this pathology can even lead to the death of the mother or fetus.
How to lower high protein?
Severe proteinuria is a condition that must be treated. Such treatment is carried out by an obstetrician-gynecologist together with a therapist. In some cases, a nephrologist is also involved in making recommendations. This mainly occurs in a situation if a pregnant woman has any kidney and urinary tract diseases.
It is possible to remove adverse symptoms not only with the help of drugs. Doctors recommend to expectant mothers at this time first normalize the daily routine. Pregnant women with signs of persistent proteinuria are advised to sleep at least 8-9 hours a day. To improve falling asleep, you should ventilate the room before bedtime.
In the acute period of the disease, doctors recommend observe bed rest. If the disease is severe enough, then in such a situation, a pregnant woman can be hospitalized. Mode correction is carried out gradually. All expectant mothers should not overwork. It is better to postpone active sports and intense physical activity until after childbirth.
In order to reduce swelling and reduce the amount of protein in the urine, it is used special diet. It excludes any canned and pickled foods.
Table salt is also limited. Excessive salting of ready-made meals will only contribute to the appearance of edema on the body.
Drug therapy includes the appointment of sedatives and diuretics. To improve renal blood flow, aminophylline and magnesia sulfate are used. These substances are administered intravenously. Such treatment is carried out only in a hospital setting.
To reduce puffiness doctors prescribe diuretics. They help reduce the amount of circulating fluid in the body. Usually, small doses of diuretic drugs are used to achieve a positive effect. In severe cases, diuretics can be given parenterally.
Quite often, proteinuria is accompanied by the development arterial hypertension... In this case, antihypertensive drugs are used to normalize high blood pressure. Their selection is carried out individually, taking into account the initial values of blood pressure. These drugs are prescribed by a therapist. If in a pregnant woman arterial hypertension is accompanied by the development of proteinuria, then in this case she must be registered with the dispensary.
In severe cases, some vascular funds... Their use also prevents the development of cerebral edema. These means include "Reopoliglyukin" and "Mannitol". These drugs are administered intravenously. To improve overall well-being, you may also need 20% Albumin or plasma solution.
To improve the filtration function of the kidneys, it is imperative the drinking regime is limited. To do this, the expectant mother should drink no more than 1 liter of liquid per day. Various berry and fruit fruit drinks can also be used as drinks. It is important to remember that they should not be heavily sweetened before eating. Also, doctors recommend drinking a rosehip broth prepared at home.
If pathological changes have arisen due to rheumatological diseases, then in this case it is required to consult a rheumatologist. The doctor will prescribe the appropriate treatment. In some clinical situations, long-term therapy is required. The appearance of protein in the urine requires the expectant mother to consult a doctor.
For the prevention of dangerous complications, it is imperative to control and monitor the development of this condition. In this case, the expectant mother will need to visit the clinic a little more often.
