Pregnancy

Deciphering tests pregnant

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The main purpose of a woman, determined by nature itself, is the birth of a child. However, his carrying is a complex physiological process that has a huge impact on the female body.

All organs work with double load, the baby grows every day, increasing my mother's stomach. This leads to compression of the uterus back of the abdominal cavity and the infringement of some internal organs, located at close distance from her.

In some cases, a woman during the period of childbearing can develop various pathological processes, the most unfavorable of which are inflammatory diseases of the urogenital system and renal failure.

In order to avoid the development of severe complications of pregnancy, a woman must constantly monitor urine indicators. In our article we will talk about why it is necessary to pass a general urine analysis during pregnancy, how to properly collect biological material for OAM, as indicated by the parameters of the clinical analysis of the urine of a pregnant woman.

Purpose of the study

During the period of bearing a child, the load on the kidneys is double - they remove the waste products of not only the woman herself, but also the fetus. The increasing uterus squeezes the visceral organs (located in the abdominal cavity), this condition can cause urine stagnation, swelling of the renal parenchyma and an upward inflammatory process that develops as a result of infection of the bladder.

The immune system of the expectant mother is weakened, because of the rearrangement of the hormonal background of the woman, the ureters relax, which provokes infection of the kidneys or exacerbation of chronic diseases of the urinary system.

With the help of urine analysis in pregnant women, it is possible to identify such a pathological complication as preeclampsia - a condition that threatens the life of both the expectant mother and baby, which is manifested by edema, increased blood pressure, convulsions and loss of protein by the body.

An early urine test for pregnancy is prescribed by practicing obstetrician-gynecologists:

  • for the timely diagnosis of various pathological processes in the urinary system and other internal organs,
  • monitoring the course of the detected disease and evaluating the rationality of the course of the therapeutic therapy being conducted.

Deciphering a urine test during pregnancy plays an important role in the dynamic monitoring of the health status of the female body. Urine study is recommended to carry out according to the following algorithm:

  • in the first trimester - 1 time in 4 weeks,
  • in II and III - 1 time in 2 weeks,
  • starting from the 35th week - 1 time in 7 days.

How to collect urine?

Urine during pregnancy shall be in the morning, after a night delay. Biological fluid is collected in a special sterile container after washing the external genitalia. The basic rule of preparation for the analysis - a woman should refuse to use drugs and use products containing dyes.

Deciphering a general urine test during pregnancy will contain more reliable information if a medium portion of the biomaterial is delivered for the study.

To obtain it you need:

  1. The first jet to release into the toilet.
  2. Without interrupting bladder emptying and without touching the container to the body, collect a second portion of urine (approximately 100 ml).
  3. Finish urinating into the toilet.

On the container you need to clearly indicate your data. The collected urine must be delivered to the laboratory center after two hours.

Read more about the rules for collecting urine for analysis in pregnant women can be found in this article.

If the results of general clinical examination of urine contain information about a high level of bacteriuria (the presence of a large number of pathogenic microorganisms in the urine), it is necessary to make a bacteriological culture. The biological material for this analysis is taken from the woman by a catheter.

Urinalysis Indicators

Laboratory testing of urine includes the study of its organoleptic properties (which are assessed using vision, smell, touch), physicochemical properties, determination of biochemical parameters and microscopic evaluation of sediment.

The table below contains indicators of the norm of general clinical research.

How to take?

Blood is taken from a finger in the morning on an empty stomach. Overnight should not eat fatty foods, it is also desirable to refrain from stress.

We read the analysis

Hemoglobin
During pregnancy, the permissible lower limit of normal is 110. If the hemoglobin level is lower, the woman has anemia, the child does not receive enough nutrients and oxygen and may begin to lag behind in development. Therefore, with a low level of hemoglobin, pregnant women need treatment.
Platelets
A decrease in the platelet level (below 180.0) requires additional testing of the blood coagulation system, since it is the platelets that help prevent massive bleeding during labor.
White blood cells
If their level is elevated (more than 9.0), this may be a sign of infection in a pregnant woman.

If you feel bad, this is not a reason to refuse to pass tests. Contact a paid medical center or laboratory who take tests at home, and receive the results by email.

We read the analysis

Protein in urine
The presence of protein in the urine can be a symptom of pregnancy complications - preeclampsia (toxicosis of the second half of pregnancy).
Glucose
The presence of glucose may indicate diabetes in pregnancy. If you suspect this disease, the doctor will prescribe stress tests to determine the level of sugar in the blood.
White blood cells
An increase in the number of leukocytes (the norm is not more than 4) and the presence of bacteria can be a sign of cystitis or pyelonephritis - inflammation of the bladder and kidneys during pregnancy.
Ketone bodies
Their presence may indicate that the body lacks nutrients due to severe toxicosis.

Zakome need a urine test during pregnancy?

Urinalysis during pregnancy is an extremely important study that allows to evaluate the work of the kidneys and the urinary system as a whole. This is a simple study that does not require much effort from a pregnant woman, but provides very valuable information for the doctor, who, based on the results of tests, selects and adjusts the tactics of pregnancy.

In the multidisciplinary medical center GMS Clinic in Moscow, you can pass any urinalysis and get a qualitative interpretation of the analyzes.

Urinalysis in pregnancy

Usually, a general urine analysis during pregnancy is taken at each visit to the gynecologist (at least once a month), starting from the moment of registration and up to the birth itself. For a general urine test, you only need to collect the morning medium portion of urine in a dry clean container and take it to the laboratory for research. After 20-30 minutes, the results of the analysis will be known.

Such a frequent urine test is due to the increased, almost double the load that the kidneys carry when carrying a fetus. The end products of an intensively growing organism are supplied through the umbilical cord into the mother’s bloodstream and require continuous elimination. Given that the increasing uterus can squeeze the abdominal organs located on the back wall, it is necessary to constantly monitor the work of the urinary system. Thus, the slightest compression of the kidneys and urinary tract leads to stagnant urine, edema of the organ, and ascending infection coming from the bladder. In addition, immunity weakened during pregnancy and changes in hormonal levels can trigger the development of infectious inflammation of the urinary organs or exacerbation of latent chronic diseases.

An analysis of urine during pregnancy also helps not to miss the warning signs of a specific pathology of the prenatal period - late toxicosis (gestosis), which can pose a threat to the life of the mother and child. In conjunction with certain complaints and symptoms, a general analysis of urine is important in identifying the severity of gestosis and directing the efforts of doctors to prevent this formidable pathology.

In the paid Moscow Medical and Diagnostic Center GMS Clinic, you can pass urine for analysis at any time. The result of the study will be ready on the day of the analysis. And it is possible to receive decoding of the analysis on reception of our qualified specialists of obstetricians gynecologists.

How to make a general urine test as informative as possible:

  • On the eve of collecting urine for a general analysis, it is not recommended to drink plenty of mineral water, alcohol, medicinal substances (vitamins and anti-inflammatory) to eat spicy, sour, salty and overstrain - all this may affect the result of the study and give inaccurate results.
  • The required volume of urine is 100 ml.
  • It is better to collect urine for analysis in pharmacy sterile containers.
  • Urine should be collected immediately after waking up from sleep. Nighttime urine is more concentrated, so it is best to detect any changes in the work of the urinary system.
  • It is necessary to collect a medium portion of urine, previously washed with soap.
  • The faster the urine is delivered to the study, the more accurate the analysis will be. It is usually recommended to provide urine for analysis with prescription of collection not more than two hours.

Poor urinalysis during pregnancy

The presence of a “bad” urine test during pregnancy may indicate asymptomatic bacteriuria of pregnant women, gestosis, pyelonephritis of pregnant women, cystitis, urethritis and other diseases. In most cases, intense proteinuria, micro- and gross hematuria, detection of bacteria, a large number of leukocytes and cylinders in the urine require additional diagnostics (ultrasound, urinalysis according to Nechyporenko, urine culture for the detection of antibiotics) and observation of a pregnant woman in the hospital.

In the later stages of pregnancy, gestosis, that is, toxicosis of the second half of pregnancy, poses a particular danger to the mother and the fetus. When detecting increasing edema, protein in the urine, high blood pressure, a woman needs urgent hospitalization in the hospital. Launched cases of preeclampsia lead to eclampsia: the progression of edema, hypertension, the development of pain in the epigastrium, the appearance of intense headaches, passing to seizures and loss of consciousness. In some cases, even an emergency delivery does not save the fetus from death.

In addition, poor urine tests combined with high body temperature, general weakness, and lower back pain indicate an infectious disease of the kidneys or urinary tract. And the treatment of infection, as is well known, is the prescription of antibacterial drugs. In order to rule out the development of dangerous infectious complications, it is also necessary to be treated in the conditions of the obstetric department.

Therefore, if a gynecologist ascertains a “bad” urine test during pregnancy and insists on additional examination and inpatient treatment, the recommendation of a specialist should not be ignored.

Complete diagnostics of the urogenital system, including ultrasound, identify the causes of violations of the urinalysis, and not only get advice from an experienced obstetrician gynecologist and other doctors at the GMS Clinic Medical Center in Moscow.

Deciphering urine analysis during pregnancy

Decryption of urine analysis during pregnancy can only be performed by a medical practitioner. Despite the obvious indicators of the overall analysis, only a specialist with clinical thinking can evaluate the results of the study, not abstractly, but in combination with complaints, inspection data and additional diagnostics.

Urine is known to be formed in the kidneys by filtering blood plasma in the kidney glomeruli. Such a glomerular filtrate is the primary urine and contains all the components of blood plasma, except proteins: water (96%), dissolved mineral salts, a small amount of the urinary tract epithelium and cellular elements of the blood, the final products of metabolism, such as pigments, uric acid and urea. Next, the renal tubular epithelium is reabsorbed, that is, reabsorbed into the blood of 98% of the primary urine.

Interpretation of the general analysis of urine includes an assessment of odor, color and transparency, volume, acidity, relative density, microscopic examination of urinary sediment.

Colour. Urine in healthy people has a straw-yellow color, due to urochrome pigment. The urine may acquire darker coloration during edema and fluid loss, as well as in the presence of a large concentration of bile pigments in the urine (cirrhosis, hepatitis, obstructive jaundice), hemolysis. Redness of urine can be associated with the use of certain drugs and colored vegetables, as well as serious diseases of the kidneys and urinary tract, in which a large number of red blood cells (nephritis) enter the blood. Whitish urine gets color with a large concentration of phosphates or fatty inclusions.

Transparency. The urine of a healthy person is usually transparent. Pathological clouding of urine appears when a large amount of salts (oxalates, urates, phosphates) or pus is excreted.

Smell. Normally, urine does not have a pronounced unpleasant odor. When there is a large amount of ketone bodies (diabetes mellitus), the urine acquires the smell of pickled apples, and the pungent smell can be associated with the consumption of large quantities of garlic and asparagus.

Daily amount of urine. The average daily diuresis in a healthy person is 1.5-2 liters, accounting for three fourths of the fluid intake. Decrease (oliguria) or cessation of urine (anuria) is associated with:

  • A significant drop in blood pressure and blood volume during bleeding, shock, dehydration.
  • Blockage of both ureters with stones or a tumor.
  • Acute renal failure.

Relative density of urine. The specific weight of urine depends on the content of proteins, glucose, mineral salts and urea and is normally equal to 1.010 - 1.025. Changes in the density of urine in one direction or another are also found in physiological changes (of the volume of fluid consumed) and in pathological processes (diabetes, edema, diuretic drugs, chronic renal failure, diabetes insipidus).

Reaction of urine. The reaction of urine is normally weakly acidic or acidic pH 5-7. The use of plant foods shifts the acidity of urine in the alkaline side, and the use of meat food - in acid. When kidney function is abnormal, the temperature rises, diabetes mellitus, the reaction of the urine shifts to the acidic side, and vomiting, inflammation of the bladder and the edema of the edema, the reaction shifts to the alkaline side.

Protein. In the urine of a healthy person, protein is contained in a very small amount - no more than 0.002 g per liter. In diseases of the kidneys and urinary system, nephropathy of pregnant women, fever, leptospirosis, severe heart failure, anemia, hemorrhagic vasculitis, diabetes mellitus, proteinuria appears, that is, increased excretion of protein in the urine. There are also physiological causes of proteinuria:

  • Increased muscle load
  • Eating large amounts of protein foods

Urine sediment The study of urine sediment is to identify salts and cellular elements (epithelium, red blood cells, leukocytes, cylinders). Normally, the number of red blood cells in the urine is not more than 3 in the field of view. Blood in the urine appears in the following diseases:

  • Toxic kidney damage
  • Nephrosis
  • Glomerulonephritis
  • Pyelonephritis
  • Kidney injury
  • Amyloidosis
  • Kidney tuberculosis
  • Hemorrhagic diathesis
  • Hemorrhagic fever
  • Urolithiasis disease
  • Cystitis

The number of leukocytes in the urinary sediment is normally in women up to 5 in the field of view, and in men up to 3 in the field of view. An increase in the content of leukocytes in the urine (leukocyturia) is observed in inflammatory diseases of the kidneys and urinary tract, less often in tuberculosis and amyloidosis of the kidneys, acute and chronic glomerulonephritis.

Cylinders are formed in the tubules of the kidneys from protein under the influence of acidic urine. Therefore, cylinders appear only parallel to the appearance of protein in the urine and for the same reasons.

Epithelial cells line the urinary tract and appear in the urine during inflammatory processes in the mucosa. Normally, they are allocated units in the field of view.

The number of bacteria in the urine in healthy people does not exceed more than 2 thousand per 1 ml, and in patients with inflammation in the urinary organs reaches 100 thousand in 1 ml.

Urinalysis during pregnancy - the norm

The urine analysis during pregnancy is normal and does not differ from the average statistical norm. But, given all the features of the functioning of the urinary system in pregnant women, any deviations from the norm can be interpreted differently.

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Основные параметры

В период гестации мочевыделительная система претерпевает ряд изменений. Это связано с физиологическими особенностями процесса. These include:

  • expansion of the lumen of the ureters,
  • kidney hypertrophy 1.5 cm,
  • an increase in the intensity and volume of the renal blood flow.

According to this fact, normal indicators of urine analysis during pregnancy in the period of childbearing are somewhat different from the generally accepted values. The table presents the estimated values:

The presence of ketone bodies

Why is it necessary to pass an analysis?

The study can show the presence of bacteria in the biological fluid, increased white blood cell count, protein content, blood admixture, and various salts. Properly performed and performed in the laboratory, the analysis of urine in pregnant women is able to suggest the presence of pathology or, conversely, to confirm that nothing threatens the health of the woman and the fetus.

A more frequent urinalysis study during pregnancy is required if the following changes were found:

  • urine has a high concentration of pathogenic bacteria,
  • found an admixture of red blood cells in urine,
  • high level of acetone,
  • elevated glucose level (normally it should not be),
  • the appearance of protein in the biological fluid (urine during pregnancy may normally contain traces of protein structures).

If a specialist for some reason did not pay attention to these changes, or the patient cannot collect and give urine in time, then there is a risk of unpleasant consequences. They can threaten the health of the woman herself, as well as threaten the normal functioning of the fetus. These include:

  • The appearance of protein in the urine in combination with high blood pressure and the presence of edema suggests the formation of such a complication of pregnancy as late gestosis. The lack of timely initiated therapeutic measures may result in the delay of intrauterine development of the fetus, chronic hypoxia, lead to the development of eclampsia or premature birth.
  • If the glucose level is elevated, then this situation requires additional control. A single detection of sugar in pregnancy in the urine analysis may indicate eating disorders when the diet is replete with simple carbohydrates (confectionery, bakery products, some fruits). With this picture, it is enough to adjust the power and conduct a re-study. If the performance is normal, then nothing to worry about. But if in a number of tests a high level of sugar is repeated, then this is a reason for taking a test for glucose tolerance, followed by consultation with an endocrinologist. Such a tactic is necessary to exclude the manifestation of type 2 diabetes mellitus during gestation or confirm the presence of gestational diabetes mellitus.
  • High levels of acetone may indicate the development of the following diseases: toxemia in the first half of pregnancy, eclampsia, type 2 diabetes, excessive thyroid function, abuse of fatty and smoked food

Each repeated urine analysis during pregnancy requires careful decoding. It evaluates the effectiveness of the therapy.

The multiplicity of delivery of urine depends on the previous analysis result. If it is normal, then the study should be carried out once a month in the first half of gestation, and then twice a month. With any deviation of indicators, the frequency of urine analysis in pregnant women increases. For example, in the case of gestational diabetes, the result is evaluated every week.

Pathological abnormalities

What changes should be afraid of:

  • The brown tint of urine indicates a malfunction of the liver structures or the gallbladder, a dirty red tint indicates pathology of the urinary system itself, if the urine has a white tint and becomes turbid, then an increased concentration of phosphorus salts in the body can be suspected, a greenish tint indicates the purulent nature of the inflammatory damage to the kidneys or bladder.
  • Increased turbidity of the biological fluid indicates the presence of leukocytes in it, epithelial cells (for example, from the vagina), purulent secretions (due to the influence of pathogenic microorganisms), and protein.
  • Changing the smell of urine in the direction of a sharp and unpleasant also indicates trouble in the body. If it smells like wet apples, it indicates an excess concentration of ketone bodies (early toxicosis or diabetes mellitus becomes the cause of this phenomenon). Even the smell of urine changes when the excess content in the diet of garlic, asparagus. But the main reason for this situation is the development of inflammatory process.
  • The proportion reflects the parameters of water-salt metabolism in the body. If its rate is overestimated, then we can assume dehydration, which is often caused by the latent course of diabetes, the development of edema, the use of drugs with a diuretic effect. If the index is lowered, it indicates the development of kidney failure or hormonal imbalance. The physiological decrease in the proportion of urine can be associated with inadequate fluid intake during the day (less than 1 liter).
  • The appearance of protein in the urine above the permissible value indicates the presence of chronic stress, diabetes, dysfunction in the renal system (pyelonephritis, glomerulonephritis), pregnancy complications (late preeclampsia, eclampsia). Of the physiological factors, it is worthwhile to add excessive physical exertion and excessive consumption of protein products.
  • The appearance in the urine of pregnant sugar is the first sign of gestational diabetes. Additionally, there may be complaints of thirst, frequent urination. Physiological reasons may be a change in the parameters of the filtration function of the kidneys, when in the initial stages of gestation there is a restructuring of the body to meet the needs of the developing fetus, as well as excessive consumption of carbohydrate foods, chronic stress.
  • Changes in pH, both in the acidic side below 5.1 units and in the alkaline side above 7.1 units, equally have a negative impact on the development of pregnancy and the health of the woman. At pH below 5 units. you can suspect a lack of potassium, kidney pathology, the phenomenon of dehydration. And with elevated values, we can talk about dysfunction in the thyroid gland, diseases of the gastrointestinal tract, infectious inflammatory process.
  • If the result of the analysis contains exceeded red blood cell values, and the clinical picture is supplemented with symptoms of anemia, hypertension or fever, then one of the following reasons can be suggested: compression of the hollow organs of the excretory system, traumatic lesion of the ureteral mucosa with stones, a sharp development of hormonal imbalance, the presence of an inflammatory pathological process, sexually transmitted infections.

How to collect correctly

To correctly assess what a urine test during pregnancy shows, it must be properly collected. The presence of protein in the biological fluid or the presence of bacteria does not always indicate the development of the pathological process. Quite often, the reason is the ingress of vaginal discharge.

To avoid improper deciphering of urine will require adherence to elementary techniques:

  • It is necessary to urinate in a sterile container, which can be purchased in the pharmacy chain,
  • On the eve of the study you should not eat fatty and fried foods, pickles and pickles,
  • 12 hours before the delivery of the urine it is necessary to stop taking all medications, including vitamins,
  • about two days not to be sexually active,
  • reduce the intensity of physical activity,
  • to urinate the external genital organs before urination, insert a swab from gauze into the vagina to prevent the vaginal discharge from entering,
  • it is better to urinate in the morning, the laboratory complex includes an average portion of a biological fluid,
  • Do not save the urine more than two hours.

What to do if the result of the analysis is not happy

Having received poor results of urine analysis during pregnancy, do not immediately despair.

First, it is necessary to eliminate the wrong collection of urine. This will require, following all the recommendations of a specialist, to pass a repeated analysis. Secondly, it is worth remembering that in the second half of gestation, when the pressure and load on the kidneys exceed the physiologically acceptable, changes in the results of the urine are common. Thirdly, a diagnosis is not made on a single-time OAM, there should be at least two bad analyzes obtained with an interval of 2-3 days.

It is important to understand that getting pregnant is not always difficult. And taking out 9 months and giving birth to a healthy baby is a joint work of the future mother and her local gynecologist.

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