The purpose of the study of general urine analysis during pregnancy

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

During pregnancy, the kidneys work with a double load, removing not only the metabolic products of the mother, but also the fetus. Also, the growing uterus compresses the abdominal organs, including the ureters, which can lead to stagnation of urine, swelling of the kidneys and an ascending infection penetrating the kidneys from the bladder. nine0003

In addition, immunity during gestation is weakened, hormonal changes lead to relaxation of the ureters, which also provokes an infectious process or exacerbation of chronic infectious diseases of the urinary system.

Urinalysis during pregnancy is prescribed by practicing obstetrician-gynecologists:

• for the timely diagnosis of various pathological processes in the urinary system and other internal organs; nine0014
• monitoring the course of the detected disease and evaluating the rationality of the course of ongoing medical therapy.

Urine analysis during pregnancy helps not to miss the alarming signs of a specific pathology of the prenatal period - late toxicosis (preeclampsia), which can pose a threat to the life of the mother and child. Together with certain complaints and symptoms, a general urinalysis is important in identifying the severity of preeclampsia and directing the efforts of doctors to prevent this formidable pathology. nine0003

Frequency of urinalysis

Pregnant women are prescribed a urinalysis more often than other laboratory tests.

Urinalysis for pregnant women:

• every 4 weeks in the first trimester,
• times every 2 weeks in the second and early third trimester;
• weekly starting at 35 weeks.

Usually, a urinalysis during pregnancy is given at each visit to the gynecologist, from the moment of registration to the birth itself. nine0003

Pregnancy urine.

In the analysis of urine during pregnancy, the doctor evaluates both physical and chemical parameters - color, transparency, density (specific gravity) and pH , and inorganic urine sediment - the number of formed elements, salts, microbes, protein.

The acidity or pH of the urine will depend on nutrition: with a predominantly vegetable and dairy diet, urine will be slightly alkaline, with an abundance of meat - acidic. An increase in the acidity of urine, together with an increase in the number of leukocytes, is an early sign of an infectious process in the urinary tract. Timely intervention allows you to stop the inflammatory process at the initial stage, which reduces the dose and duration of taking antibacterial drugs used to combat urinary tract infections. The easiest way to monitor urine pH at home is to use a portable urine analyzer. nine0003

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 a violation of kidney function or the presence of serious diseases (diabetes, nephropathy).

Main indicators and possible deviations from the norm in the analysis

Consider the main indicators of urine analysis.

1. Acetone in urine during pregnancy.
   The acidity of the urine changes with toxicosis with vomiting, causing both acidification of the urine and its alkalization, depending on the activities carried out and the severity of vomiting. One of the signs of toxicosis and its rather pronounced condition is the appearance of acetone (ketone bodies) in the urine. They change the pH of urine to the acid side. nine0064
2. Cloudy urine during pregnancy.
   If the transparency of urine is disturbed, the presence of mucus, microbes or leukocytes, protein can be suspected in it, which indicates a serious inflammatory process in the kidneys or urinary system. The appearance of a precipitate may indicate urolithiasis or metabolic disorders.
   
3. Protein in urine during pregnancy.
   One particularly worrisome 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 are quite acceptable. These are the features of the blood circulation of the kidneys and the result of increasing loads on them. nine0002 An increase in the amount of protein in the general urine test serves as a signal for a more detailed examination of the woman. An increase in the protein level above 0.033 g/l may indicate the development of a serious pregnancy complication - nephropathy or preeclampsia. Also, the appearance of protein in the urine can be a sign of infectious and inflammatory diseases of the kidneys - glomerulonephritis, pyelonephritis.

   In such conditions, immediate hospitalization is necessary, a comprehensive examination and treatment, and with a gestational age of more than 32 weeks and a progressive deterioration in kidney function, early delivery is necessary to save the life of the child and mother. Nephropathy leads to increased pressure, 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 fetal death. nine0003

   Timely detection of an increase in the level of protein in the urine allows you to identify preeclampsia in the early stages and avoid the formidable complications associated with it. For monitoring at home, a portable urine analyzer is best.
   

4. Bacteria in urine during pregnancy.

   During pregnancy, urinalysis of women often reveals bacteria. This phenomenon is quite common and is due to the peculiarities of the structure of the genitourinary system of women, the proximity to the genital organs of the rectum and the weakening of the immune defense of the mucous membranes from microbial attacks during pregnancy. The appearance of microbes in the urine may be a defect in the collection of urine and a consequence of insufficient hygiene of the genital organs, or it may be a symptom of a serious urinary tract infection - pyelonephritis, cystitis. Especially often in the urine is sown E. coli or staphylococcus aureus. nine0003

   A separate option may be asymptomatic bacteriuria : the appearance of microbes in the urine in the complete absence of signs of inflammation from the urogenital area. This condition requires close monitoring by a doctor, as it can be the initial stage of serious infections of the kidneys and bladder. Asymptomatic bacteriuria with a large number of microbial bodies per milliliter of urine can lead to premature birth, threatened abortion, intrauterine infection of the fetus, and other complications. nine0003

   If microbes are found in the general urine test, an additional urine culture is performed during pregnancy. This analysis is carried out according to the 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.
   

5. Leukocytes in urine during pregnancy.
   The presence of leukocytes in the urine indicates an inflammatory process in the genitourinary system. This is accompanied by a serious condition of the pregnant woman, and is extremely dangerous for the fetus - it can threaten intrauterine death, premature birth, fetal hypoxia, and placental problems. nine0002 The easiest way to monitor your white blood cell count at home is to use a portable urine analyzer.
   

6. Erythrocytes in urine during pregnancy.
   The appearance of erythrocytes in the urine is an unfavorable symptom, since normally they should be completely absent in a pregnant woman. Blood in the urine may appear as microhematuria, which is a very small number of red blood cells. This happens with cystitis, urolithiasis, pyelonephritis, in the initial stage of preeclampsia. nine0002 Sometimes blood in the urine is visible to the naked eye, which is called gross hematuria. This occurs with nephritis, glomerunonephritis with nephrotic syndrome, with severe gestosis. These conditions are extremely dangerous for the mother and fetus, require immediate hospitalization and active therapy, and sometimes an emergency caesarean section to save the baby and the mother herself.
   

7. Urine sugar during pregnancy
   If diabetes or gestational diabetes is suspected, urine glucose (sugar) is measured. In case of violation of carbohydrate metabolism, associated both with the 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. Usually, an increase in sugar levels is accompanied by an increase in the density of urine, a sharp increase in the volume of urine released (up to three to five liters) and intense thirst. nine0002 The easiest way to monitor the level of red blood cells and urine sugar at home is to use a portable urine analyzer.

How to collect urine for analysis?

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

On the eve of sampling, exclude medications (vitamins, diuretics, hormones, antibiotics and other medicines) and coloring foods (carrots, beets, asparagus, cranberries, blueberries, etc.). nine0003

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

First of all, before collecting urine, it is necessary to carefully perform hygiene of the external genital organs. To prevent the vaginal environment from entering the urine sample, a swab must be inserted into the vagina. Avoid touching 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 part of the urine, interrupting at the end of the process and finishing urinating into the toilet. nine0003

​

Poor urinalysis during pregnancy

The presence of a “bad” urinalysis during pregnancy may indicate asymptomatic bacteriuria of pregnant women, preeclampsia, pyelonephritis of pregnant women, cystitis, urethritis and other diseases. In most cases of intense proteinuria, micro- and macrohematuria, the detection of bacteria, a large number of leukocytes and cylinders in the urine, it requires additional diagnostics (ultrasound, urine culture for flora with antibiotic sensitivity), and, sometimes, observation of a pregnant woman in a hospital. nine0003

In late pregnancy, preeclampsia, that is, toxicosis of the second half of pregnancy, is of particular danger to the mother and fetus. When detecting increasing edema, protein in the urine, high blood pressure, a woman needs urgent hospitalization in a hospital. Launched cases of gestosis lead to eclampsia: the progression of edema, arterial hypertension, the development of pain in the epigastrium, the appearance of intense headaches, passing to convulsions and loss of consciousness. In some cases, even emergency delivery does not save the fetus from death. nine0003

In addition, poor urinalysis combined with high body temperature, general weakness, and back pain indicate an infection of the kidneys or urinary tract. Treatment consists in the appointment of antibacterial drugs, if necessary, drainage of the urinary tract. To exclude the development of dangerous infectious complications, in some cases it is necessary to be treated in an obstetric department.

How not to miss the early signs of pregnancy complications, respond to them in time, how to decide whether an urgent consultation with a doctor is needed, and, sometimes, hospitalization in the obstetric department of a hospital? nine0003

Need to monitor urinalysis at home. The use of a portable urine analyzer makes it possible to transfer the monitoring results to the doctor who is observing you online, which allows you to choose the optimal treatment tactics.

Pregnancy urinalysis, interpretation, bad or normal

Poor pregnancy urinalysis

The presence of a "bad" urine test during pregnancy may indicate asymptomatic bacteriuria of pregnant women, preeclampsia, pyelonephritis of pregnant women, cystitis, urethritis and other diseases. In most cases of intense proteinuria, micro- and macrohematuria, detection of bacteria, a large number of leukocytes and cylinders in the urine, it requires additional diagnostics (ultrasound, urinalysis according to Nechiporenko, urine culture for flora with determination of sensitivity to antibiotics) and observation of a pregnant woman in a hospital. nine0003

In late pregnancy, preeclampsia, that is, toxicosis of the second half of pregnancy, is of particular danger to the mother and fetus. When detecting increasing edema, protein in the urine, high blood pressure, a woman needs urgent hospitalization in a hospital. Launched cases of gestosis lead to eclampsia: the progression of edema, arterial hypertension, the development of pain in the epigastrium, the appearance of intense headaches, passing to convulsions and loss of consciousness. In some cases, even emergency delivery does not save the fetus from death. nine0003

In addition, poor urinalysis combined with high body temperature, general weakness, and back pain indicate an infection of the kidneys or urinary tract. And the treatment of infection, as you know, is the appointment of antibacterial drugs. To exclude the development of dangerous infectious complications, it is also necessary to be treated in an obstetric department.

Therefore, if a gynecologist states a “bad” urine test during pregnancy and insists on additional examination and inpatient treatment, the recommendation of a specialist should not be neglected. nine0003

You can undergo a complete diagnosis of the genitourinary system, including ultrasound, identify the causes of violations of the general analysis of urine and not only, get recommendations from an experienced obstetrician gynecologist and doctors of other specialties at the GMS Clinic medical center in Moscow.

Interpretation of urine test during pregnancy

The interpretation of a urine test during pregnancy can only be legally performed by a medical practitioner. Despite the obvious indicators of a general analysis, only a specialist with clinical thinking can evaluate the results of the study, not abstractly, but in conjunction with complaints, examination data and additional diagnostics. nine0003

Urine is known to be formed in the kidneys by filtration of blood plasma in the glomeruli. This glomerular filtrate is primary urine and contains all components of blood plasma, except for proteins: water (96%), dissolved mineral salts, a small amount of urinary tract epithelium and blood cells, metabolic end products such as pigments, uric acid and urea. Further, the epithelium of the renal tubules is reabsorbed, that is, reverse absorption into the blood 98% primary urine.

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

Colour. Urine in healthy people has a straw-yellow color, due to the pigment urochrome. Urine can acquire a darker color with edema and loss of fluid, as well as in the presence of a high concentration of bile pigments in the urine (cirrhosis, hepatitis, obstructive jaundice), hemolysis. Redness of the 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 enter the blood (nephritis). Whitish color urine gets with a high concentration of phosphates or fatty inclusions. nine0003

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

Odor. Normally, urine does not have a pronounced unpleasant odor. With a large number of ketone bodies (diabetes mellitus), urine acquires the smell of pickled apples, and a pungent odor may be associated with the use of large amounts 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 consumed. Reduced (oliguria) or cessation of urine output (anuria) is associated with:

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

Relative density of urine. The specific gravity of urine depends on the content of proteins, glucose, mineral salts and urea and is normally 1.010 - 1.025. Changes in the density of urine in one direction or another occur both with physiological changes (from the volume of fluid consumed) and with pathological processes (diabetes mellitus, edema, diuretic drugs, chronic renal failure, diabetes insipidus). nine0003

Urine reaction. The reaction of urine normally has a slightly acidic or acidic reaction pH 5-7. The use of plant foods shifts the acidity of urine to the alkaline side, and the use of meat foods to the acid side. In case of impaired renal function, fever, diabetes mellitus, the reaction of urine shifts to the acid side, and vomiting, inflammation of the bladder and convergence of 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. With 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 food

Urine sediment. The study of urine sediment is to identify salts and cellular elements (epithelium, erythrocytes, leukocytes, cylinders). Normally, the number of erythrocytes in the urine is no more than 3 per field of view. The admixture of blood in the urine appears in the following diseases:

• Toxic damage to the kidneys
• Nephroses
• Glomerulonephritis
• Pyelonephritis
• Injuries of the kidneys
• Amyloidosis
• Tuberculosis of the kidneys
• Hemorrhagic diathesis
• Hemorrhagic fever
• Urolithiasis
• Cystitis

The number of leukocytes in the urinary sediment is normally up to 5 in women 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.

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